Validity and reliability of the quality of midwifery childbirth care from women’s perspectives scale among Japanese women: a cross-sectional online survey

Traditional evaluations of maternity care have predominantly relied on outcome-based indicators. However, quality should also be evaluated based on women’s psychological and emotional responses. Seven key concepts reflecting enhanced midwifery care from women’s perspectives were identified. As existing tools do not fully capture these elements, the Quality of Midwifery Childbirth Care from Women’s Perspectives (QuMiCW) scale was developed. This cross-sectional study aimed to examine the validity and reliability of the Japanese version of the QuMiCW scale. A web-based survey was conducted among Japanese women who had given birth within the past 10 years. Structural validity was examined through an exploratory factor analysis (EFA) using the least squares method and promax rotation on half of the sample, followed by confirmatory factor analysis (CFA) using covariance structure analysis on the remaining half. Test-retest reliability was evaluated by calculating the Spearman’s rank correlation coefficient (ρ) between the initial and 1-month follow-up scores. Internal consistency was assessed using Cronbach’s α. For hypothesis testing, correlations between the QuMiCW and both the Japanese version of the Birth Satisfaction Scale-Revised (BSS-R) and the Japanese Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) Version B were examined. The study was conducted in accordance with COnsensus-based Standards for the selection of health Measurement Instruments guidelines. A total of 714 women were included in the analysis. EFA of the 18 items identified three factors: “fulfilling needs and support,” “protection of dignity,” and “empowerment and reassurance.” The CFA model demonstrated a good fit (GF index = 0.990, adjusted goodness of fit index = 0.987, normed fit index = 0.987, relative fit index = 0.985, and standardized root mean square residual = 0.047). Test-retest reliability was high, with a ρ of 0.71 for the total score. Internal consistency was also high (Cronbach’s α coefficient = 0.94). A positive correlation was observed with the BSS-R (ρ = 0.53), whereas a negative correlation was found with the JW-DEQ version B (ρ = −0.44). The QuMiCW demonstrated reliability and validity among Japanese mothers. It may be used to evaluate and improve midwifery childbirth care from a woman’s perspective.