The Labor and Delivery Satisfaction Index: The Development and Evaluation of a Soft Outcome Measure

ABSTRACT: Recognizing the need to assess the caring aspects of childbirth care, we developed a Labor and Delivery Satisfaction Index (LADSI) for use in clinical trials of options for delivery. Thirty‐eight items were constructed after extensive consultation with recent mothers and clinicians, and each was worded as a statement for ratings of agreement or disagreement on a six‐point scale. Fifty‐nine unselected women completed the index two days postpartum, and 35 of them completed it again at four to six weeks postpartum. Analysis of these data showed the LADSI to have stability over time with a correlation of 0.67 between test and retest, face validity to mothers and clinicians, construct validity by showing significantly different satisfaction scores among groups expected a priori to differ significantly, and enough internal consistency to use total scores (average item‐total correlations of 0.5), but not enough to use subcomponent scores (Cronbach's alpha = 0.35). On the basis of this study, differences of as little as 10 percent in the scores of different groups of women on the LADSI represent clinically important differences in levels of satisfaction with labor and delivery.