The development and initial validation of the Tokophobia Severity Scale

Objective: Severe fear of childbirth (tokophobia; TP) is an understudied and under-recognised phenomenon that has significant implications for maternal mental health during pregnancy, labour and delivery. The few existing measures of TP are limited by lengthy formats, difficulty scoring and a narrow definition of the TP construct. Method: The current study examined the psychometric properties of a newly developed self-report scale, the Tokophobia Severity Scale (TSS), in a sample of 122 female participants. Results: The final measure consisted of 13 items. The scale demonstrated a unidimensional structure and items demonstrated excellent internal consistency (α =.93) and adequate convergent validity with the Wijma Delivery Expectancy/Experience Questionnaire-Version A. Conclusions: The findings provide preliminary evidence to suggest that the TSS is a brief, valid and reliable measure that may be used in the future to identify women with TP who may benefit from psychological and supportive interventions prior to delivery.