Beliefs in pregnancy: the psychometric properties of the German version of the birth beliefs scale (BBS).

Authors

Gaby Schmidt, Stefan Dietsche, Kathrin Stoll, Astrid Müller, Mechthild M Gross

Published in

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. Volume 49. Pages 101247. Jun 14, 2026. Epub Jun 14, 2026.

Abstract

To evaluate the psychometric properties of the German Birth Beliefs Scale (G-BBS) in a large sample of pregnant women in Germany, and its potential utility for women-centred birth counselling, and respectful maternity care.
In this cross-sectional study pregnant women were recruited across antenatal care settings in Bremen, Germany (n = 602). We assessed item performance, internal consistency, structural validity using confirmatory factor analysis of the original two-factor model, and post hoc split-sample exploratory analyses with confirmatory testing. Construct validity was examined using correlations with self-efficacy, life satisfaction, desire for control, and general anxiety. Known-groups validity was tested by women's preferred place of birth. Methodological quality and interpretation followed Consensus-based Standards for the selection of Health Measurement Instruments (COSMIN) criteria for measurement properties.
Internal consistency was acceptable for both subscales. Hypothesis testing supported construct validity: natural birth beliefs were associated with higher self-efficacy and life satisfaction, whereas medicalised birth beliefs were associated with lower self-efficacy and life satisfaction; associations with general anxiety and desire for control were small. Known-groups validity was strong, with clear gradients in subscale scores by preferred place of birth. However, structural validity was not established: confirmatory analyses did not support the original two-factor structure, and a shortened structure derived from exploratory analyses could not be confirmed either.
The G-BBS showed promising evidence for construct and known-groups validity, but insufficient structural validity according to COSMIN. Refinement informed by qualitative work and independent psychometric re-testing are needed before routine clinical use or standardised subscale scoring in Germany.

PMID:
42320077
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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