The Oxford Worries about Labour Scale: maternal concerns about labour and birth

Summary

Initially a study was carried out on the measurement characteristics of a short (9-item) multi-dimensional measure of worry about labour and birth, the Oxford Worries about Labour Scale OWLS-9), and its use in a large scale study of women's experience of care. Data utilised were from 2960 women who participated in the 2006 National Maternity Survey.

Key findings

• Exploratory factor analysis revealed three sub-scales within the instrument assessing specific concerns about labour pain and distress, pre-labour uncertainty and interventions.
• The item asking about 'embarassment', may be of particular use in working with specific groups of women who may be more likely to raise it as a concern. It was concluded that used antenatally the scale could be a useful research instrument and a measure of worry about labour and birth that could inform the content of antenatal education and support.

This instrument has been included in maternity surveys in Australia, the UK and other parts of Europe.

In conclusion, compared with White women, twice as many ethnic minority women worried about pain and discomfort, not knowing how long labour would take and about embarrassment during labour and birth.Implications for practice include improved information-giving and support in providing the individualised care that women need.

Concern about women’s worries and expectations of labour and birth, especially those of first time mothers led to the development of a short instrument to assess concerns about childbirth. A validation study was carried out which describes the measurement characteristics of a short 9 or 10 item multi-dimensional measure of worry about labour and birth, the Oxford Worries about Labour Scale (OWLS), and its use in a large-scale study of women's experience of care. The data utilised were from 2960 women who participated in the 2006 National Maternity Survey, a random sample of women who had recently given birth in England.

Key findings

• Exploratory factor analysis revealed three sub-scales within the instrument assessing specific concerns about labour pain and distress, pre-labour uncertainty and interventions.

• The characteristics of each sub-scale revealed good divergent and discriminant validity.

• The labour and distress subscale score was found to be significantly associated with both self-reported 'baby blues' and self-reported postnatal depression.

In summary the findings suggest that the three sub-scales can be utilised as well as the full-scale instrument. Used antenatally, the scale offers a short, relevant and clinically useful measure of worry about labour and birth. The scale is currently in use in non-UK contexts.

Publications

Journal Articles

• Redshaw M, Martin C, Rowe R, Hockley C. The Oxford Worries about Labour Scale: Women's experience and measurement characteristics of a measure of maternal concern about labour and birth. Psychol Health Med. 2009;14(3):354-66.
• Redshaw MM, Heikkila KK. Ethnic differences in women's worries about labour and birth. Ethn Health. 2011;10.1080/13557858.2011.561302:1-11.