A two-item visual analogue scale for fear of birth · Haines et al. 2011
How do you feel right now about the approaching birth?
Drag each marker along the line to show how you feel.
Calm—Worried
No fear—Strong fear
—
Move both markers
Incomplete
Drag both lines to compute the FOBS score (mean of the two).
Scoring. Each line is scored 0–100. The FOBS score is the mean of the two; higher scores indicate greater fear of birth. A score of ≥60 is commonly used to identify significant fear of birth — it should prompt a fuller assessment, not serve as a stand-alone diagnosis of tocophobia.
Evidence & Citations
Sources behind the FOBS scoring and the ≥60 cut-off
1. Haines H, Pallant JF, Karlström A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery. 2011;27(4):560–567. doi:10.1016/j.midw.2010.05.004 · PMID 20598787 ✅ VERIFIED
Original FOBS pilot. Defines the two 100-mm VAS lines (calm/worried; no fear/strong fear) and mean scoring, 0–100.
2. Haines HM, Pallant JF, Fenwick J, Gamble J, Creedy DK, Toohill J, Hildingsson I. Identifying women who are afraid of giving birth: a comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort. Sex Reprod Healthc. 2015;6(4):204–210. PMID 26614602 · ⚠️ DOI to confirm (likely 10.1016/j.srhc.2015.05.002)
ROC validation of FOBS cut-points against W-DEQ-A ≥85 (n=1410); strong correlation (Spearman ρ=0.66). Basis for refining the FOBS threshold.
3. Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19(2):84–97. doi:10.3109/01674829809048501 · PMID 9638601 ✅ VERIFIED
The W-DEQ-A reference standard (≥85) against which the FOBS cut-off was calibrated.
On the ≥60 cut-off. Early use followed Rouhe et al.'s VAS cut-off of 50; testing against W-DEQ-A ≥85 refined it to 54, and with clinical feedback ≥60 became the commonly applied threshold for identifying fear of birth. The cut-off is a screening flag, not a diagnostic criterion.
