Psychometric Properties of the Arabic Version of the Childbirth Fear-Prior to Pregnancy Scale (CFPP) in a Lebanese...

Primary tokophobia is a potent and pathological fear of pregnancy and childbirth. This condition can affect both nulliparous women and childless men and compel them to entirely refrain from parenthood, thus leading to a childless life. However, the dearth of validated Arabic scales assessing this construct hinders research in Arabic-speaking populations. Therefore, this study aims to assess the psychometric properties of the Childbirth Fear-Prior to Pregnancy scale (CFPP) within the Lebanese population.

We recruited 1269 participants (651 nulliparous women and 618 childless men) in a cross-sectional study via social media snowball sampling. The questionnaire included the CFPP scale and other Arabic-validated measures of primary tokophobia and psychological distress.

The confirmatory factor analysis of the CFPP scale confirmed its unidimensional nature, and the scale's reliability was excellent. In addition, the CFPP scale demonstrated gender invariance. Convergent validity was established by strong correlations between the CFPP scale and the Tokophobia Severity Scale (TSS) in women as well as the Fathers' Fear of Childbirth Scale (FFCS) in men. Modest, but significant correlations between the CFPP scores and anxiety/depression measures also suggested that the scale specifically captures childbirth fear rather than psychological distress, supporting its divergent validity.

Validating the Arabic CFPP scale for both women and men in an understudied Arabic population, our study offers a valuable tool for identifying childbirth fear prior to pregnancy. This validated scale can improve detection, inform support services, and ultimately benefit both men and women experiencing primary tokophobia. Furthermore, our study paves the way for cross-cultural research tackling cultural influences on primary tokophobia, particularly in non-Western countries.