Questionnaire development: midwives' knowledge and attitude on liberal birthing position in 2nd stage

Area of Science:

• Obstetrics and Gynecology
• Midwifery Practice
• Healthcare Education

Background:

• Improving women's childbirth experience and ensuring maternal-fetal safety are global healthcare priorities.
• Liberal birthing positions allow women to choose comfortable labor positions, with midwives playing a key role in the second stage.
• Assessing midwives' knowledge and attitudes is crucial for enhancing the use of liberal birthing positions, but lacks standardized tools.

Purpose of the Study:

• To develop and validate a reliable questionnaire to assess midwives' knowledge and attitudes toward liberal birthing positions in the second stage of labor.
• To identify potential gaps in midwives' understanding and acceptance of flexible laboring positions.
• To create a tool that can inform targeted educational interventions for healthcare professionals.

Main Methods:

• A Delphi expert consultation process was employed to develop the questionnaire, informed by literature review and clinical practice.
• Midwives participated in rating the questionnaire's reliability and validity.
• Statistical analyses included Cronbach's alpha for internal reliability, expert consultation for content validity, convergent validity tests for internal consistency, and exploratory factor analysis for structural validity.

Main Results:

• The knowledge section, refined to 28 items across 4 factors, demonstrated strong internal consistency (Cronbach's alpha = 0.890) and validity (S-CVI=0.98).
• The attitudes section, comprising 19 items across 2 factors, also showed good reliability (Cronbach's alpha = 0.879) and validity (S-CVI=0.93).
• All validity and reliability metrics, including factor loadings and correlation coefficients, met established thresholds, confirming the questionnaire's robustness.

Conclusions:

• The developed questionnaire exhibits good validity and reliability for assessing midwives' knowledge and attitudes regarding liberal birthing positions.
• This validated tool can effectively identify specific areas for improvement in midwives' understanding and application of flexible laboring positions.
• The questionnaire serves as a valuable resource for educators to design targeted training programs, ultimately enhancing the quality of intrapartum care.