This study compared the efficacy of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and the Childbirth Attitudes Questionnaire (CAQ) in assessing fear of childbirth (FOC) among hospitalized pregnant women, aiming to identify a practical screening tool. A total of 184 pregnant women were recruited from the Northwest Women's and Children's Hospital using convenience sampling. Data were collected through the General Demographic Questionnaire, Fear of Birth Scale (FOBS), W-DEQ, and CAQ. Using the FOBS as a reference, the diagnostic performance of the W-DEQ and CAQ was evaluated via receiver operating characteristic curves and Bayesian discriminant analysis. The area under the curve (AUC) for the W-DEQ (0.888) was significantly higher than that of the CAQ (0.789; Z = -2.189, p < 0.05). Optimal cutoff values were 80.5 for the W-DEQ and 31.5 for the CAQ. Cross-validation revealed accuracy rates of 75.6% and 70.7%, respectively. The incidence of FOC, as assessed by the W-DEQ, CAQ, and FOBS, was 29.9%, 43.9%, and 37.2%. Both tools demonstrated good reliability and validity, but the W-DEQ showed superior performance. It is recommended as the preferred tool for assessing FOC among pregnant women in China due to its comprehensive evaluation capacity.