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CFPP Measure

The Childbirth Fear Prior to Pregnancy (CFPP) scale measures anticipatory fear among young adults associated with a hypothetical pregnancy. The tool has 10 items that are measured on a six-point Likert scale, resulting in a total score between 10 to 60. The CFPP scale measures fear of labour pain, and fears about not being able to cope during labour and birth (5 items), fear of complications (3 items), and fear of irreversible physical changes (2 items).

The following translations have been published: German, Icelandic, Polish, Spanish, Portuguese (Brazil), Turkish, Chinese, Vietnamese, Lebanese and Persian.

Download the English version of the survey that was used in the cross-country study here.

Bibliography

Only includes published studies that used the CFPP scale with women and/or men prior to pregnancy.

2013 -2015 (studies used 6 item precursor of CFPP scale)

  • Stoll, K., Hall, W., Carty, E., & Janssen, P. (2014). Why are young Canadians afraid of birth? A survey study of childbirth fear and birth preferences among Canadian university students. Midwifery, 30(3), 220–226. https://doi.org/10.1016/j.midw.2013.07.017
  • Edmonds, J. K., Cwiertniewicz, T., & Stoll, K. (2015). A survey of childbirth preferences and attitudes among young women prior to pregnancy. The Journal of Perinatal Education, 24(2), 93–101. https://doi.org/10.1891/1058-1243.24.2.93
  • Stoll, K., Edmonds, J., & Hall, W. (2015). Fear of childbirth and preference for cesarean delivery among young American women before childbirth: A survey study. Birth, 42(3), 270–276. https://doi.org/10.1111/birt.12178

2016

  • Stoll, K., Hauck, Y., Downe, S., Edmonds, J., Gross, M. M., Malott, A., McNiven, P., Swift, E., Thomson, G., & Hall, W. (2016). Cross cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy. Sexual & Reproductive Healthcare, 8, 49–54. https://doi.org/10.1016/j.srhc.2016.02.004 (Article that introduced the 10 item CFPP)
  • Hauck, Y. L., Stoll, K., Hall, W., & Downie, J. (2016). Association between childbirth attitudes and fear on birth preferences of a future generation of Australian parents. Women and Birth, 29(6), 511–517. https://doi.org/10.1016/j.wombi.2016.05.001
  • Swift, E. M., Gottfredsdóttir, H., Zoëga, H., Gross, M. M., & Stoll, K. (2016). Opting for natural birth: A survey of birth intentions among young Icelandic women. Sexual & Reproductive Healthcare, 11, 41–46. https://doi.org/10.1016/j.srhc.2016.09.006

2017

  • Stoll, K., Hauck, Y. L., Downe, S., Payne, D., & Hall, W. A. (2017). Preference for cesarean section in young nulligravid women in eight OECD countries and implications for reproductive health education. Reproductive Health, 14(1), Article 116. https://doi.org/10.1186/s12978-017-0354-x
  • Thomson, G., Stoll, K., Downe, S., & Hall, W. (2017). Negative impressions of childbirth in a North-West England student population. Journal of Psychosomatic Obstetrics & Gynecology, 38(1), 37–44. https://doi.org/10.1080/0167482X.2016.1216960

2018

  • Stoll, K., Edmonds, J., Sadler, M., Thomson, G., McAra-Couper, J., Swift, E., Malott, A., Gross, M. M., Streffing, J., Downe, S., & the ICAPP Study Team. (2018). A cross-country survey of attitudes toward childbirth technologies and interventions among university students. Women and Birth, 31(4), 252–260. https://doi.org/10.1016/j.wombi.2017.10.002
  • Taşhan, T., & Uçar, T. (2018). Gebelik öncesi doğum korkusu ölçeğinin Türkçe uyarlaması: Kadın ve erkeklerde geçerlik ve güvenirlik çalışması [Turkish adaptation of the childbirth fear prior to pregnancy scale: A validity and reliability study in women and men]. Acibadem Universitesi Saglik Bilimleri Dergisi, 9(4), 433–440. https://doi.org/10.31067/0.2018.43

2019

  • Stoll, K., Downe, S., Edmonds, J., Gross, M. M., Malott, A., McAra-Couper, J., Sadler, M., Thomson, G., & the ICAPP Study Team. (2019). A survey of university students’ preferences for midwifery care and community birth options in eight high-income countries. Journal of Midwifery & Women’s Health, 64(4), 444–452. https://doi.org/10.1111/jmwh.12966
  • Weeks, F., Sadler, M., & Stoll, K. (2019). Preference for cesarean attitudes in a Chilean sample of young adults. Women and Birth, 32(6), e551–e557. https://doi.org/10.1016/j.wombi.2019.01.001

2021

  • Miller, Y. D., & Danoy-Monet, M. (2021). Reproducing fear: The effect of birth stories on nulligravid women’s birth preferences. BMC Pregnancy and Childbirth, 21, Article 451. https://doi.org/10.1186/s12884-021-03944-w
  • Samios, C., Townsend, M., & Newton, T. (2021). Self-compassion predicts less fear of childbirth in childless women: The mediating role of birth beliefs. Psychology & Health, 36(11), 1336–1351. https://doi.org/10.1080/08870446.2020.1846737
  • Sunay, Z., Altıparmak, S., Okyay, E. K., Yilmaz, A. N., & Ucar, T. (2021). The effect of midwifery students’ coping styles and moods on childbirth fear prior to pregnancy. International Journal of Caring Sciences, 14(3), 1801–1810.
  • Swift, E. M., Zoëga, H., Stoll, K., Avery, M., & Gottfredsdóttir, H. (2021). Enhanced antenatal care: Combining one-to-one and group antenatal care models to increase childbirth education and address childbirth fear. Women and Birth, 34(4), 381–388. https://doi.org/10.1016/j.wombi.2020.06.008
  • Tomazin, K. J. C., Miot, H. A., Stoll, K., Gonçalves, I. R., Spiri, W. C., Felipe, T. R. L., & Parada, C. M. G. L. (2021). Cross-cultural adaptation and validation of the childbirth fear prior to pregnancy scale in Brazil. The Open Nursing Journal, 15, 179–185. https://doi.org/10.2174/1874434602115010179

2022

  • Ataman, H., & Dissiz, M. (2022). Premenstrual syndrome and childbirth fear prior to pregnancy in young women: An association and cross-sectional study. Revista da Associação Médica Brasileira, 68(7), 898–903. https://doi.org/10.1590/1806-9282.20211211
  • Clemons, J. H., Payne, D., Garrett, N., McAra-Couper, J., Farry, A., Swift, E. M., & Stoll, K. (2022). Gaining insight from future mothers: A survey of attitudes and perspectives of childbirth. Midwifery, 115, Article 103499. https://doi.org/10.1016/j.midw.2022.103499
  • Okyay, E., Ucar, T., & Tashan, S. (2022). Predictors regarding childbirth fear prior to pregnancy: A study on female and male students. Medicine Science | International Medical Journal, 11(3), 1063–1068. https://doi.org/10.5455/medscience.2021.09.296
  • Rondung, E., Magnusson, S., & Ternström, E. (2022). Preconception fear of childbirth: Experiences and needs of women fearing childbirth before first pregnancy. Reproductive Health, 19, Article 222. https://doi.org/10.1186/s12978-022-01512-9
  • Rublein, L., & Muschalla, B. (2022). Childbirth fear, birth-related mindset and knowledge in non-pregnant women without birth experience. BMC Pregnancy and Childbirth, 22, Article 257. https://doi.org/10.1186/s12884-022-04582-6
  • Ruzgar, E., & Gurlek Kisacik, O. (2022). Pre-pregnancy fear of childbirth in Turkish nursing students: How does the obstetrics and gynecology nursing lesson affect this fear? International Journal of Caring Sciences, 15(1), 406–416.
  • Şahin, E., & Yazici, S. (2022). Effects of a parenting preparation course on preferred mode of delivery, fear of childbirth, and perception of traumatic childbirth in midwifery students. Journal of Gorgan University of Medical Sciences, 19(2), 45–53. https://doi.org/10.29252/jgbfnm.19.2.45

2023

  • Aktaş Reyhan, F., & Dağlı, E. (2023). Determination of pre-pregnancy fear of childbirth levels in Turkish and Syrian refugee individuals with no children: A comparative study. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 19, Article 100225. https://doi.org/10.1016/j.eurox.2023.100225
  • Xu, J., Li, L., Ma, X. Q., Zhang, M., Qiao, J., Redding, S. R., & Wang, H. (2023). Fertility intentions, parenting attitudes, and fear of childbirth among college students in China: A cross-sectional study. Journal of Pediatric and Adolescent Gynecology, 36(1), 65–71. https://doi.org/10.1016/j.jpag.2022.07.015

2024

  • Mizobata, V. N., Castro, A. B., de Lima Parada, C. M. G., de Avila, M. A. G., Gibim, B. N., & Jamas, M. T. (2024). Internal structure of the Brazilian online version of the childbirth fear prior to pregnancy scale. The Open Nursing Journal, 18, Article e18744346287785. https://doi.org/10.2174/0118744346287785240122061914
  • Odabasi, N. C., Calim, S. I., & Demirci, H. (2024). Are future midwives afraid of vaginal deliveries? Journal of Education and Research in Nursing, 21(2), 143–149.
  • Tosun, H., & Uğur, N. (2024). Primary fears of childbirth of couples who have not yet had children in Türkiye. Clinical and Experimental Health Sciences, 14(4), 926–933. https://doi.org/10.33808/clinexphealthsci.1109965
  • Yetişmiş, H. Y., & et al. (2024). The relationship between midwifery students’ attitudes towards marriage and birth fears. The Journal of Health Academics, 11(1).

2025

  • Erbil, N., Boyraz Yanık, H. G., & Yıldız, G. (2025). Personality traits, stress, anxiety, depression levels, fear of childbirth, and affecting factors in Turkish university students. Depression and Anxiety, 2025, Article 5130737. https://doi.org/10.1155/2025/5130737
  • Ho, T. T., Nguyen, T. H., & Dao-Tran, T. H. (2025). The Vietnamese version of the childbirth fear prior to pregnancy scale: A validation study. Sexual & Reproductive Healthcare, 44, Article 101120. https://doi.org/10.1016/j.srhc.2024.101120
  • Surma, P., Micek, A., Bednarek-Chałuda, M., Stoll, K., & Nenko, I. (2025). Confidence in knowledge, childbirth fear, and preference for cesarean birth among Polish women: A cross-sectional study. European Journal of Public Health, Article ckaf179. https://doi.org/10.1093/eurpub/ckaf179