A Rasch-Based Dimension Of Delivery Experience: Spontaneous versus Medically Assisted Conception.

Aims and objectives. To devise a set of indices representative of a latent dimension of delivery perception, aimed at the assessment of birth experience after both spontaneous and medically assisted conception. Background. Birth experience is of great importance for its prognostic value for the woman and newborn’s psychophysical well-being, especially after the experience of assisted reproduction technology. Up to date, a delivery perception assessment measure targeted to both spontaneously and medically assisted conceiving women does not exist yet. Design. Measure development and psychometric analysis; quantitative and qualitative analysis of women’s delivery experience measures. Methods. Thirty-one indices characterising seven relevant aspects of birth perception were devised from the literature and evaluated on a 4-point Likert-type scale by 98 childbearing women (54 spontaneously and 44 medically assisted conceiving) in the 24–48 hours postpartum time frame. Women’s obstetric history information was also collected. The dimension psychometric definition was pursued within a latent trait perspective, by applying the many-facet Rasch measurement model. Results. A latent delivery perception dimension composed of 18 valid and reliable indices, qualifying six labour and delivery perception clinical aspects, was identified. Medically assisted conceiving women evidenced a more positive birth perception, but when analysing each index, they showed peculiar intense worries about themselves and their baby’s health, even if they felt more satisfied, safer and stronger in almost every labour and birth aspect. Conclusions. The delivery perception dimension integrates all relevant birth experience aspects in 18 easy-to-administer indices and provides a valid, reliable and feasible assessment tool for both the clinical practice and research purposes. Relevance to clinical practice. The delivery perception dimension clearly discriminates between women’s types of conception and identifies relevant differences in their birth experience, which are interesting for their clinical implications within a prognostic and intervention perspective of support provision in the early postpartum period.

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