Dimensional structure and internal consistency of the Brazilian Portuguese version of the Mistreatment of Women during Childbirth Questionnaire

07/08/2026

AI Summary

Evaluated configural and metric structure and internal consistency of a Brazilian Portuguese adaptation using factor analyses on 1,881 childbirth cases.
Final instrument comprised 17 items across four dimensions: verbal abuse, neglect and disrespect, stigma, discrimination and lack of privacy, and inappropriate vaginal examinations.
Model fit acceptable, most dimensions showed reasonable internal consistency, but stigma, discrimination and lack of privacy dimension underperformed; recommends further psychometric validation and cautious use.

Rev Bras Epidemiol. 2026 Jul 31;29:e260036. doi: 10.1590/1980-549720260036. eCollection 2026.

ABSTRACT

OBJECTIVE: This study aimed to evaluate the configural and metric structure, as well as internal consistency, of the Brazilian Portuguese adaptation of an instrument designed to assess mistreatment during childbirth.

METHODS: Data were drawn from the “Birth in Brazil” II, carried out in 2023/2024, comprising 1,881 women hospitalized for childbirth in the state of Rio de Janeiro, Brazil. Initially, confirmatory factor analysis was conducted to test the original dimensional structure. Due to an inadequate model, exploratory factor analysis was performed to reassess the factorial structure. Applying predefined criteria, items presenting cross-loadings or possible residual correlations were removed. The remaining items were subsequently evaluated using confirmatory factor analysis, and reliability was assessed using Cronbach’s α coefficients.

RESULTS: The final solution comprised 17 items distributed across four dimensions: verbal abuse; neglect and disrespect; stigma, discrimination and lack of privacy; and innappropriate vaginal examinations. The final model presented acceptable fit indices, satisfactory factorial definition, and no item redundancy. Most dimensions showed reasonable internal consistency, except the stigma, discrimination, and lack of privacydimension.

CONCLUSION: The findings suggest that further psychometric evaluation is necessary to establish the instrument’s validity and reliability. Its use for assessing mistreatment during childbirth or obstetric violence in Brazil should be done with caution. Future psychometric studies using this instrument are recommended.

PMID:42561244 | DOI:10.1590/1980-549720260036

Document this CPD