W-DEQ

The W-DEQ measures fear of childbirth by asking participants to rate their depth of feeling against 33 expectations and experiences before birth (version A) and after birth (version B) [51] . Questions are presented in positive and negative formats on a six point Likert scale from 0 - 5 requiring reverse scoring of positively formulated questions. A score equal to or lower than 37 is considered low fear, a score between 38 and 65 equates to moderate fear and a score equal to or higher than 66 represents a high level of fear [20] .

EPDS

The EPDS is widely used in perinatal research and useful in screening for antenatal and postnatal depression [24] [52] . The scale is a simple self-report questionnaire with 10 items. Women were asked to select one of four possible responses to each question. Each item is scored from 0 - 3 and summed to produce a total score. The range of scores is from 0 - 30 with higher scores indicating more negative feelings. The EPDS has been endorsed as a screening tool in the antenatal and postnatal Australian maternity population [53] . EPDS scores of >12 in the antenatal or postnatal period have been recommended as an indicator of probable depression but not diagnostic of depression [53] .

DCS

The DCS is a validated psychometric 16 item scale, which investigates concepts that can compromise or facilitate effective decision making (O’Connor, 2010). A score of 25 or lower (out of a possible score of 100) on the Decisional Conflict Scale (DCS) indicates an ability to make decisions (O’Connor, 2010). Scores ≥ 37.5 are associated with decision delay or feeling unsure about implementing decisions. Participants identify on a 5 point Likert scale of 1 = strongly disagree to 5 = strongly agree their certainty or uncertainty about decisions when there are tradeoffs of outcomes in a health related decision. The DCS has relevance to this study because determining a mode of birth for women who have fear of childbirth or who have had a previous CS can create uncertainty where the “individual feels uninformed about the alternatives, risks and benefits; is unclear about their personal values; or feels unsupported in making a choice or feels pressured to choose a course of action” [25] .

EuroQol (EQ-5D)

EQ-5D developed by the international EuroQol Group [26] [27] is a 6-item self-report measure of health across the 5 dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression [54] . The scale has been validated in healthy and unwell persons and can be used as a stand-alone measure or in conjunction with other psychometric instruments. To gain a baseline of women’s health status on the day of entering the study one question pertaining to experiencing moderate or extreme pain and another on experiencing anxiety/depression were used from this scale.

CKQ

Childbirth Knowledge Questionnaire is a list of 9-items that each assess knowledge of behavioural techniques which may assist during the labour and birth process, attendance at antenatal classes, vicarious experiences relating to viewing and reading about childbirth and perceived knowledge about childbirth. Although Drummond and Rickwood [28] reported fair internal consistency (Cronbach’s alpha = 0.68) analysis for the current study indicated that the items were not related and did not form a scale with psychometric properties. Furthermore, different response options were used for different items preventing the calculation of a reliability coefficient. Therefore a global score was calculated using 0 = No, 1 = Yes for dichotomised questions and for five item responses 0 = None to 4 = A lot or extremely; was assigned for a total possible score of 18. A question pertaining to behavioural techniques was not included.

SSPS

SSPS is a brief 5-item scale validated for Australian childbearing women [28] . The measure includes items that examine verbal support received from a partner and/or significant others specific to the woman’s current pregnancy and upcoming birth. The tool uses a 5-point Likert scale ranging from “never” or “none” to “very often” or “a lot” with higher scores indicating the woman has more social support. Internal consistency was reported using Cronbach’s alpha and found to be 0.61 which is low [28] . Analysis for the current study indicated that the items were not related and did not form a scale with psychometric properties. A global score was calculated using 0 = None or never to 4 = A lot or very often, for a total possible score of 20.