# Cross-cultural validation of the birth memories and recall questionnaire: a cross-sectional study among Chinese postpartum women

## TL;DR

This study validated a questionnaire to assess birth memories in Chinese postpartum women, showing it is reliable and useful for understanding their psychological well-being.

## Contribution

The study cross-culturally adapted and validated the Birth Memories and Recall Questionnaire for Chinese postpartum women.

## Key findings

- The Chinese version of the questionnaire showed good content validity, with a scale-level content validity index of 0.95.
- The questionnaire demonstrated strong psychometric properties, including good convergent and discriminant validity and high internal consistency.
- Women with probable PPD or CB-PTSD reported distinct memory patterns, such as more emotional memory and sensory recall.

## Abstract

Birth memory is closely linked to the psychological well-being of postpartum women, highlighting the importance of its accurate assessment. However, no specialized and validated instrument is currently available in China to evaluate birth memory. This study aimed to cross-culturally adapt the Birth Memories and Recall Questionnaire for Chinese postpartum women and validate its psychometric properties.

The Birth Memories and Recall Questionnaire was translated into Chinese and culturally adapted following the Beaton model. Content validity was assessed by an expert panel. A convenience sample of 494 primiparous women, aged 18 to 49 years, who had undergone vaginal childbirth and had an infant aged 0 to 12 months, was recruited from three tertiary-level public hospitals in China. Construct validity was tested using confirmatory factor analysis, along with assessments of convergent validity, discriminant validity, and measurement invariance. Known-group validity was assessed by comparing birth memory characteristics between women with and without probable postpartum depression (PPD) and childbirth-related post-traumatic stress disorder (CB-PTSD). Reliability was established through internal consistency and test-retest reliability.

The Chinese version of the Birth Memories and Recall Questionnaire exhibited satisfactory content validity, with a scale-level content validity index of 0.95. Confirmatory factor analysis showed an acceptable model fit and supported the six-factor structure of the original questionnaire. The questionnaire demonstrated good convergent and discriminant validity, and it supported measurement invariance across PPD symptom subgroups. Women with probable PPD or CB-PTSD reported more emotional memory, reliving, centrality of memory, and involuntary recall. Women with probable PPD also reported less coherence, while those with probable CB-PTSD reported more sensory memory. The Chinese version of the questionnaire demonstrated high internal consistency, with an overall Cronbach’s alpha of 0.83 and McDonald’s omega of 0.81. Test-retest reliability was confirmed with an intra-class correlation coefficient of 0.73.

The Chinese version of the Birth Memories and Recall Questionnaire is a valid and reliable tool for assessing the birth memory characteristics of postpartum women, which will be valuable in future research and clinical practice.