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Post-partum depression and anxiety
Hi there, please fill out and submit this survey. If you have multiple children please fill out this survey reflecting on your first child.
23
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1
I agree to participate in the research study. I understand the purpose and nature of this study and I am participating voluntarily. I understand that I can withdraw from the study at any time, without any penalty or consequences.
I grant permission for the data generated from this interview to be used in the researcher's publications on this topic.
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2
This survey is to be filled out refelecting on the post-partum journey of your first born child. Do you understand?
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3
Were you ever officially diagnosed with post-partum-depression?
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NO
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4
Were you ever officially diagnosed with post-partum-anxiety?
YES
NO
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5
Did you feel as though you experienced post-partum-depression?
YES
NO
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6
Did you feel as though you experienced post-partum-anxiety?
YES
NO
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7
At what age did you have your child? (If more than one please put the age at the time of your first child)
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8
How many children do you have?
1
2
3
4+
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9
Have you ever received a mental health related diagnosis? (Other than post-partum-depression Or post-partum-anxiety)
YES
NO
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10
How supported did you feel by your spouse during your first year of motherhood?
.
Very supported
Supported
I needed more support
Unsupported
Unsupported at first, then we progressed towards my feeling supported
Supported at first, then we regressed towards my feeling unsupported
I did not have a spouse
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11
How supported did you feel by family/friends/community during the first year of motherhood?
Very Supported
Supported
I needed more support
Unsupported
Unsupported at first, then we progressed towards my feeling supported
Supported at first, then we regressed towards my feeling unsupported
I did not have family/friends/community support
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12
“Help with cooking meals would of been beneficial post-partum.”
Please rate your level of agreement with this statement
Strongly Agree
Agree
Neutral
Disagree
Strongly disagree
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13
“Help with tending to my baby would have been beneficial post-partum.”
Please rate your level of agreement with this statement
Strongly Agree
Agree
Neutral
Disagree
Strongly disagree
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14
“Help with cleaning would have been beneficial post-partum”
Please rate your level of agreement with this statement
Strongly Agree
Agree
Neutral
Disagree
Strongly disagree
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15
“Being given time to rest without interruption would have been beneficial post-partum”
Please rate your level of agreement with this statement
Strongly Agree
Agree
Neutral
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Strongly disagree
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16
“Being reassured by my spouse / family/ friends / community that I was doing a good job would have been beneficial post-partum. “
Please rate your level of agreement with this statement
Strongly Agree
Agree
Neutral
Disagree
Strongly disagree
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17
Did you feel emotionally supported post-partum?
YES
NO
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18
Did you feel parental responsibilities were fairly shared between you and your spouse?
Please skip if you did not have a spouse
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NO
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19
Did you ever express a need for more support to your spouse/ family/friends/community?
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20
Was post-partum-depression and post-partum-anxiety brought up at your 6 week check up?
YES
NO
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21
In what year were you born? (enter 4-digit birth year; for example, 1976)
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22
What is your racial or ethnic identity? (Select all that apply.)
Black
East Asian
First Nation
Indigenous
Latino
Middle Eastern
South Asian
South East Asian
White
Other
Prefer not to say
Métis
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23
In which province do you reside?
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