PURPOSE : This study aims to develop a scale to measure childbirth experience quantitatively and to evaluate reliability and validity of the scale. METHODS : This is a cohort study examining relationship between childbirth experience and following physical and psychological states of mother and child. All women who gave birth at five study centers (four birthing homes and one maternity hospital) from May 2002 to August 2003 were asked to participate in the study. A total of 2314 women were recruited and 1453 of eligible women agreed to participate. Based on the literature review and the written notes by women after childbirth, a multi-disciplinary group consisting ten specialists generated 45 items for inclusion. RESULTS : After examining the content of the items of factors and correlations between factors, the CBE-scale was presented to consist of four positive factors and 18 items ; such as Happiness (4 items), Body Sense (6 items), Discovery (5 items) and Unaffected Self Expression (3 items). It was shown that the CBE-scale was internal consistency with Cronbach's Alphas and itemtotal correlation. Concurrent validity was discussed using a question of subjective attitude towards childbirth such as "Do you feel that the other women would also have the same childbirth experience as you had?" The prediction validity was confirmed using three questions as follows. "Would you like to be pregnant again and to give a birth?", "Do you enjoy being with your baby?" and "Do you feel like holding your baby in your arm all the time?" These questions were asked repeatedly at four-month-, nine-month-and sixteen-month-visits. Students' T-test and logistic regression analysis were carried out to examine relationship between these 3 items and the scale score. CONCLUSIONS : These findings support that the CBE-scale has reliability and validity. The CBE-scale has potential to measure women's subjective experience of childbirth and contribute to an assessment of the quality of care during childbirth.
Vaccination is of great value to us. Protection from inoculation is more than the prevention of infectious disease. It is a political theme of the worldwide security pact. However, there were fear and anxiety for vaccination in the world, particularly in Japan. Japan constituted the Preventive Vaccination Law in 1948 under Allied Powers occupation. It was very enforceable law unlike any other in the world. Its broad coverage of vaccination was made up by the policy of GHQ. The law obliged Japanese people to get inoculations with domestic vaccine. It seems hat many vaccination accidents that occurred later in Japan were caused by the poor vaccine production system. The risks of vaccinations were already mentioned in GHQ documents, but it was not regarded as important in the Preventive Vaccination Law of Japan. It also caused many problems with vaccinations. GHQ/5CAP PHW improved many problems in Japanese public sanitation in postwar years, but it is also true that they left some problems for the later in Japan. The Preventive Vaccination Law continued into effect without changing its legal force after the end of the occupation, and caused smallpox vaccination evils. The forced attitude, which is military medical in the Preventive Vaccination Law, was finally over in the legal revision in 1994. These historic facts are considered a possible reason of some Japanese vaccinations avoidance.