Peer-reviewed article

The use of Childbirth Experience Questionnaire (CEQ) and Birth Satisfaction Scale-Revised (BSS-R) in comparing the experiences of mothers with and without HIV in Tanzania.

Mbwele B, Joctan ZZ, Hawkins C, Caputo M, August F et al. · 23 Nov 2025

Abstract

Introduction Mothers' experiences at birth and respectful maternal care are critical to achieving Sustainable Development Goal number 3 in Tanzania. However, little is known about the differences in perinatal experience quality between women with and without HIV. To address this gap, we compared mothers' experience at birth among women with and without HIV. Methods This cross-sectional study was conducted in four Reproductive and Child Health Clinics in Mbeya, Tanzania between June and August 2022. Childbirth experience was assessed among mothers with and without HIV 1 week after birth using the Child Birth Experience Questionnaire (CEQ) and Birth Satisfaction Scale-Revised (BSS-R) questionnaires translated to Swahili. Higher scores reflected better experiences. Using this baseline assessment, bivariate and multivariate linear regression analyses tested the associations between HIV status and other patient factors and child-birth experience scores. Results A total of 1252 mothers were invited, of which 626 (288 (46%) with HIV, mean (SD age 31.9±7.8 years)), were included. Mothers with HIV had lower scores in most CEQ and BSS-R domains compared with mothers without HIV. Significant mean CEQ score differences between mothers with and without HIV were observed in both CEQ and BSS-R scores: After adjusting for demographic factors, regression coefficients, β for CEQ scores were higher among mothers without HIV compared with mothers with HIV for: 'own capacity' 0.73, p<0.001, 'Professional support' 0.94, p<0.001 and 'Participation' 0.33, p<0.001. Similarly, β for BSS-R scores were higher among mothers without HIV for 'Quality of care provision' 0.87, p<0.001), 'Women's personal attributes' 0.27, p=0.002 and 'Stress experienced' 0.1, p=0.1. Conclusions Mothers with HIV in the postpartum period reported poorer CEQ and BSS-R scores compared with mothers without HIV. These results suggest a need to improve respectful maternity care at birth among the mothers with HIV.