Psychometric Reliability to Assess the Perception of Women’s Fulfillment of Maternity Rights

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The article is beautifully written.

 

 Highly recommend the publication after making the necessary changes.

 

Editing is needed in terms of English.

 

 

The validity of the perception of the fulfillment of birth rights (FMR) was measured according to 50 items.

We will do a factor analysis.

 

To detail the scale from 1 to 4: Likert scale, being 0="never" and 4="always"

 

Was a pilot test performed A factor analysis?

 

I would be happy to expand the explanation on The Positive and Negative Affect Schedule (PANAS)

 

I would appreciate it if you could explain confirmatory factor analysis in line 225, it's hard to understand.

 

Please explain more The Figure 2

 

Expand on the limitations of the study.

Comments on the Quality of English Language

The article is beautifully written.

 

 Highly recommend the publication after making the necessary changes.

 

Editing is needed in terms of English.

 

 

The validity of the perception of the fulfillment of birth rights (FMR) was measured according to 50 items.

We will do a factor analysis.

 

To detail the scale from 1 to 4: Likert scale, being 0="never" and 4="always"

 

Was a pilot test performed A factor analysis?

 

I would be happy to expand the explanation on The Positive and Negative Affect Schedule (PANAS)

 

I would appreciate it if you could explain confirmatory factor analysis in line 225, it's hard to understand.

 

Please explain more The Figure 2

 

Expand on the limitations of the study.

Author Response

Comments: The article is beautifully written. Highly recommend the publication after making the necessary changes. Editing is needed in terms of English.

• The validity of the perception of the fulfillment of birth rights (FMR) was measured according to 50 items.
• We will do a factor analysis.
• To detail the scale from 1 to 4: Likert scale, being 0="never" and 4="always"

Response: Thank you for your time reviewing our study. English editing has been done, and modifications were made according to your recommendations. Additionally, your queries have been addressed below.

 

Comments: Was a pilot test performed A factor analysis?

Response: factorial analysis was not carried out on the pilot sample since piloting serves to cultural adaptations and identify lexical troubles that could misinterpret the data. This initial phase is carried out with a small sample size, which makes factor analysis difficult.

 

Comments: I would be happy to expand the explanation on The Positive and Negative Affect Schedule (PANAS).

Response: Information related to the scoring has been added in the Materials and Methods section. Additionally, information regarding PANAS, and our data has been included in lines 351-356.

 

Comments: I would appreciate it if you could explain confirmatory factor analysis in line 225, it's hard to understand.

Response: We have clarified the CFA interpretation in the text as follow: “CFA provides a rigorous method to ensure that data align with expected theoretical constructs, improving the reliability and validity of the FMR measurements. The path diagram allows to identify the relationships between the factors detected by EFA. The values indicate the standardized variance explained by equations”.

 

Comments: Please explain more The Figure 2.

Response: The data in the figure have been clarified as follows: “The direct score of factors was calculated by averaging the items within the factor. The standardized factor score was obtained by summing the products of the standardized coefficients from CFA. All these variables were positively correlated.” Additionally, the calculation of these scores is reported in the Materials and Methods section (Lines 261-263).

 

Comments: Expand on the limitations of the study.

Response: The limitations of the study were expanded (lines 411-415).

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

Thank you for the opportunity to review your article. It addresses the significant issue of women's health rights during the perinatal period.

I appreciate your attention to the critical role that eliminating mistreatment of women during childbirth plays in reducing maternal and neonatal mortality and morbidity.

Thank you for developing a tool to measure perceptions of the realization of women's rights from pregnancy through childbirth to early postpartum.

I find your study thoughtful and meticulously conducted. The validation of the instrument was well-executed, demonstrating its consistency and reliability.

 

I have only one comment regarding the structure of the "Materials and Methods" section. For instance, it may be better to order the subsections as Participants, Procedure, Instrument, Analysis, etc. Combining Participants and Study Design into one subsection does not provide a clear description.

 

It is also unfortunate that the study was conducted solely online, as this limitation may have excluded some women from participating. I believe this restriction should be emphasis in the manuscript.

The development of this tool is particularly valuable, as it has practical applications in clinical practice and research aimed at improving the quality of maternal care.

Author Response

Comments: Thank you for the opportunity to review your article. It addresses the significant issue of women's health rights during the perinatal period. I appreciate your attention to the critical role that eliminating mistreatment of women during childbirth plays in reducing maternal and neonatal mortality and morbidity. Thank you for developing a tool to measure perceptions of the realization of women's rights from pregnancy through childbirth to early postpartum. I find your study thoughtful and meticulously conducted. The validation of the instrument was well-executed, demonstrating its consistency and reliability.

Response: Thank you for your time reviewing our study and your kindly words. In addition, your recommendations were addressed and responded below.

 

Comments: I have only one comment regarding the structure of the "Materials and Methods" section. For instance, it may be better to order the subsections as Participants, Procedure, Instrument, Analysis, etc. Combining Participants and Study Design into one subsection does not provide a clear description.

Response: Thank you for this value recommendation that was applied in the main text.

 

Comments: It is also unfortunate that the study was conducted solely online, as this limitation may have excluded some women from participating. I believe this restriction should be emphasis in the manuscript.

Response: This concern has been addressed in the limitations of the study as follows: “Additionally, the enrollment process was performed via social media, which may affect the supervision of responses and identity verification. In-person recruitment allows for interviewer-participant interaction and the collection of latent variables that can influence scores.”

 

Comments: The development of this tool is particularly valuable, as it has practical applications in clinical practice and research aimed at improving the quality of maternal care.

Response: Thank you again. The authors also though that this kind of tools can be implemented in the clinical practices.

Reviewer 3 Report

Comments and Suggestions for Authors

I believe it will provide valuable insights into women's experiences as mothers. However, there is an issue with the study's description.

 

Is the tool used in this study a newly developed instrument, or is it a validation of an existing tool that has been translated? If it is a newly developed tool, please provide a detailed description of the development process. If it is an existing tool that has been translated, please describe the translation process. Currently, these details are missing. Given that both EFA and CFA were conducted, it appears that a new tool may have been used. Please elaborate on the development process of the original items.

 

Additionally, you mentioned another tool in the introduction. Please clarify the differences between this tool and the one used in your study.

Author Response

Comments: I believe it will provide valuable insights into women's experiences as mothers. However, there is an issue with the study's description.

Response: Thank you for your time reviewing our study. In addition, your indications and questions were addressed and responded below.

 

Comments: Is the tool used in this study a newly developed instrument, or is it a validation of an existing tool that has been translated? If it is a newly developed tool, please provide a detailed description of the development process. If it is an existing tool that has been translated, please describe the translation process. Currently, these details are missing. Given that both EFA and CFA were conducted, it appears that a new tool may have been used. Please elaborate on the development process of the original items.

Response: Thank you for this indication and sorry for the confusion. Exactly, the FMR tool is a new instrument, and as the reviewer comment, it was performed EFA and CFA of the items and scores. Additional information was implemented in the new section 2.1. Development of the fulfillment in maternity rights instrument.

 

Comments: Additionally, you mentioned another tool in the introduction. Please clarify the differences between this tool and the one used in your study.

Response: It was added information to compare MOR and FMR instruments in the lines 309-316.