Measuring woman's perception of support and control during childbirth: Psychometric proprieties of the SCIB scale in an Italian sample

Objective: This study aims to develop an Italian version of the Support and Control in Birth (SCIB) and to test its reliability and validity. Methods: The sample included 414 post-partum women, who were recruited 24/48 h after giving birth. A studyspecific online questionnaire was designed to collect sociodemographic information and administer the translated Italian version of the SCIB. The construct validity of the Italian SCIB was first analyzed using Confirmatory Factor Analysis (CFA). Based on metrics showing a poor fit, Exploratory Factor Analysis (EFA) was then executed. The reliability of the instrument was verified through Cronbach's alpha for each subscale and the total scale and test-retest correlation coefficient. Results: CFA was performed to test the original three-factor theoretical model; however, the CFA solution showed a poor fit. Specifically, chi 2 = 2100, df= 492, p < 0.001, RMSEA = 0.0888 (0.085 - 0.0928), and CFI = 0.45. The theoretical model did not adequately fit the observed data. Thus, EFA was conducted; it yielded a six-factor structure. The six factors were named: Support: healthcare professionals' guidance; Support: healthcare professionals' presence; External control: control over medical procedures; External control: control over the informational process; Internal control: control over emotional and physical reactions; Internal control: control over pain. These factors replicate the originals dimensions, each divided into two further subfactors. Conclusion: Findings enhance knowledge about childbirth by cross-culturally adapting an instrument to assess perceptions of control and support, fundamental factors in birth experience. SCIB could help health professionals to monitor women's childbirth experiences and introduce tailored interventions.