Translation, cultural adaptation, and psychometric validation of the Malay version of the Disrespect and Mistreatment During Childbirth Questionnaire

Mistreatment during childbirth, including neglect, verbal abuse, and non-consented procedures, undermines respectful maternity care and negatively affects maternal health outcomes. Despite growing recognition of this issue, no culturally validated instrument has been available to assess mistreatment during childbirth in the Malaysian context. This study aimed to translate, culturally adapt, and psychometrically validate the Malay version of the Disrespect and Mistreatment during Childbirth Questionnaire (DMCQ). A cross-sectional study was conducted among postpartum women within 12 months of delivery attending health facilities in Kelantan. The original DMCQ underwent forward–backward translation and expert harmonization to ensure conceptual and cultural equivalence. Content and face validity were assessed by maternal health experts and postpartum women, while construct validity was examined using exploratory and confirmatory factor analyses, followed by internal consistency reliability testing. All items demonstrated excellent content validity and clear comprehension during face validation. Exploratory factor analysis supported a five-factor structure comprising negative interactions with healthcare providers, separation from the newborn, medical intrusiveness, verbal mistreatment, and pain experience. Confirmatory factor analysis indicated acceptable model fit (χ 2 (140) = 197.07, CFI = 0.955, TLI = 0.945, RMSEA = 0.054). Internal consistency ranged from moderate to high across domains, with theoretically important items retained despite lower factor loadings. Overall, the Malay DMCQ demonstrated acceptable psychometric properties as a foundational tool for assessing mistreatment during childbirth in Malaysia and provides a culturally appropriate basis for future research, monitoring, and quality improvement efforts.