Psychometric properties of the City Birth Trauma Scale in Black trauma-exposed women

Background: Black women in the USA, who face disproportionate risks of obstetric complications and adverse birth outcomes, may be at heightened risk of birth-related post-traumatic stress symptoms. However, the City Birth Trauma Scale (BiTS) has not yet been psychometrically evaluated in this population.Objective: This study examined the psychometric properties of the BiTS, including internal consistency, convergent and divergent validity, and factor structure, among Black postpartum trauma-exposed women.Method: In total, 130 women who were 6–8 weeks postpartum completed the BiTS, along with validated measures of post-traumatic stress disorder (PTSD), depression, and anxiety. Confirmatory factor analysis (CFA) was conducted to assess BiTS factor structure. Internal consistency, convergent and divergent validity, and PTSD diagnostic prevalence were also examined.Results: The BiTS demonstrated excellent internal consistency (α = 0.91) and strong convergent and divergent validity with PTSD, depression, and anxiety measures. CFA supported a two-factor model (birth-related symptoms and general symptoms subscales) with good model fit. One-third (33.6%) of women reported their birth as traumatic and met criterion A (e.g. the belief that she or her baby would die during childbirth). Using the BiTS, 4.6% of women met full DSM-5 diagnostic criteria for PTSD, while 7.6% were above the established BiTS diagnostic cut-off for probable PTSD diagnosis.Conclusion: The BiTS demonstrates strong psychometric properties in Black postpartum trauma-exposed women.