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Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R)

Nespoli, Antonella; Colciago, Elisabetta; Fumagalli, Simona; Locatelli, Anna; Hollins Martin, Caroline J.; Martin, Colin R.


Antonella Nespoli

Elisabetta Colciago

Simona Fumagalli

Anna Locatelli

Caroline J. Hollins Martin

Colin R. Martin


To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on BSS-R assessed birth satisfaction.

Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth.

Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis.

The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population.

On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.


Nespoli, A., Colciago, E., Fumagalli, S., Locatelli, A., Hollins Martin, C. J., & Martin, C. R. (in press). Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R). Journal of reproductive and infant psychology, 1-16.

Journal Article Type Article
Acceptance Date Sep 30, 2020
Online Publication Date Oct 21, 2020
Deposit Date Oct 26, 2020
Publicly Available Date Oct 22, 2021
Journal Journal of Reproductive and Infant Psychology
Print ISSN 0264-6838
Electronic ISSN 1469-672X
Publisher Routledge
Peer Reviewed Peer Reviewed
Pages 1-16
Keywords Birth Satisfaction Scale-Revised (BSS-R); Birth satisfaction; Maternal satisfaction; Validation; Midwifery care
Public URL
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Article (314 Kb)

Copyright Statement
©2020 The authors. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder

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