EMPOWERED TO BIRTH
Thank you so much for taking the time filling out this survey! Your responses will help us better understand the journeys of women like you and provide insights to empower others on their path to a mindful and connected birth. The survey is anonymous and will take approximately 20 minutes to complete. Feel free to answer with honesty and detail. Some of the outcomes will be used (anonymously) in my book Empowered to birth. Thank you for sharing your story and helping create a tool that will inspire and support more women!
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General information
At what age did you get pregnant of your FIRST child?
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What age is your first born now?
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In what country were you born?
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In what country were you living when you got pregnant?
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What do you do for a living?
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What is the highest level of education you have completed?
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Less than high school
High school
Some college / University
College diploma / Certificate
Undergraduate degree
Masters / Graduate degree
Doctorate
Prefer not to answer
Other
What is your marital status?
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Single
Married
In a relationship
Divorced
Widowed
Other
What is your employment status after having your first born child?
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Employed full time
Employed part time
Self-employed
Stay at home mom
Student
Other
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Cultural context
In your culture, what would you say is the norm on childbirth?
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Natural birth in hospital
Humanized birth in hospital
C-section
Natural home birth
Natural home birth in bath tub
Medicated birth
Un-medicated birth
I have no idea
What beliefs were you holding around childbirth before your actual (pregnancy and birthing) experience and the preparation for it?
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What about your family and social group; How would you describe their perspective on the matter?
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Before your experience of childbirth and the preparation of it, what was your idea on how and where you would give birth? (multiple answers possible)
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Natural birth in hospital
Humanized birth in hospital
C-section
Natural home birth
Natural home birth in bath tub
Medicated birth
Un-medicated birth
Otro
Can you elaborate on WHY you had that idea?
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Did you, when you got pregnant, receive any information regarding having a natural un-medicated birth?
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Yes
No
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Are you aware of how you came into this world (your mothers childbirth experience)?
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Yes
No
No, but I would like to know
Otro
What impact do you think the cultural beliefs have on the way woman confront the experience of giving birth?
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Do you believe childbirth is always something painful and horrific? Or do you believe in the bodies biology and the possibility for it being a harmonious experience?
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Painful and horrific, its all I ever see
Believe in bodies design and harmonious childbirth, just don't know how
Believe in bodies design and harmonious childbirth, I have seen woman experiencing this
Neither
I am not sure what to believe
Would you say our thoughts and believes and how we see childbirth have an impact on the actual experience? If so, what do you believe would help you get the outcome you most desire? If not, why so?
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Did you feel that it was necessary for a doctor to be present at your birth for it to be safe?
Yes, the idea to have a doctor present gave me peace of mind
No, I trusted that I could give birth without a doctor present
I wasn’t sure, but I preferred to have medical assistance available
I wasn’t sure, but I preferred to try without medical assistance.
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Was you pregnancy planned / desired?
Yes, it was planned
Not planned but very much desired to be a mom
Not planned at all, not sure what to think
Prefer not to answer
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Fears and expectations
Did you have fears regarding the experience of giving birth?
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Yes
No
Otro
What were your initial fears regarding giving birth?
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Fear of pain during childbirth
Fear of complications during pregnancy
Fear of complications during childbirth
Fear of losing control during childbirth
Fear for the postpartum recovery
Fear of body changes
Fear of motherhood and parenting
Fear of high spendings
Fear of the impact on your career
Fear of negatively impacting romantic relationship
Fear of not having enough support
Fear of pressure of others regarding birthing choice
Fear of losing independence
Fear of changing routine
All of the above
None of the above
I didn't really focus on preparing myself
I had no fears at all
Please elaborate more on your above mentioned fears or worries:
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How did you mentally and emotionally prepare to confront these fears?
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Do you consider that these fears were instilled because of external information or experiences?
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Yes
No
Please elaborate:
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Preparation
Before you got pregnant, did you have any knowledge on how the female body works during childbirth, what parts of the body and hormones are involved?
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Yes very much
Bits and pieces
Not really
Not at all
How did you prepare for childbirth?
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Did you participate in childbirth preparation courses?
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Yes
No
What did you do to prepare?
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Read books
Listen to podcasts
Consult medics
Consult other mothers
Healthy eating habits
Working out, strengthening the body
Practice mindfulness like meditations and Breathwork
Practice visualizing my ideal birth
Study the bodies functions of pregnancy and labor
Take courses
None of the above
Other
What medical appointments, tests, or procedures did you have during your pregnancy? (Check all that apply)
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Regular prenatal check-ups
Consultation with a high-risk pregnancy specialist
First-trimester ultrasound
20-week anatomy scan
Third-trimester ultrasound
Fetal monitoring (NST)
Initial blood tests (blood type, iron levels, infections)
Glucose test for gestational diabetes
Group B Strep (GBS) test
Genetic or anomaly screening tests
Blood pressure and uterine growth measurements
Baby's heartbeat monitoring
Amniotic fluid assessment
Influenza (flu) vaccine
Whooping cough (Tdap) vaccine
COVID-19 vaccine
Non of the above
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After preparation did your initial view on how and where you where going to have birth change?
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Yes
No, it stayed the same
I started doubting
Please elaborate on why your view it changed or did not change:
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Did you feel supported emotionally during the pregnancy?
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Yes
More or less
No
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Childbirth experience
What ended up being your childbirth experience?
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Natural birth in hospital
Humanized birth in hospital
C-section
Natural home birth
Natural home birth in bath tub
Medicated birth
Un-medicated birth
Other
Did you receive any of the following interventions during your labor and/or after your baby's birth? (Check all that apply)
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Frequent dilation checks
Continuous fetal monitoring
Artificial rupture of membranes
Labor induction (oxytocin/Pitocin, etc.)
Labor augmentation (oxytocin/Pitocin, etc.)
Administration of intravenous (IV) fluids
Restriction of food and drink
Use of pain relief medication (epidural, opioids, etc.)
Episiotomy (incision in the perineal area)
Use of forceps
Use of vacuum extraction
Emergency cesarean section
Manual removal of placenta
Administration of oxytocin to expel the placenta
Manual uterine examination
Suturing for tear or episiotomy
Use of postpartum pain medication
Immediate cord clamping
Immediate separation from the mother for pediatric examination
Suctioning of mucus from mouth and nose
Vitamin K injection
Immediate vaccination (e.g., hepatitis B)
Administration of antibiotic eye drops or ointment (e.g., erythromycin)
Immediate baby bath
Use of formula instead of allowing immediate breastfeeding
No interventions
Other intervention (next field)
What other intervention(s) happened before, during or after labor? (only fill out if it applies
Did you experience any form of abuse by the people who assisted you during labor, such as not respecting your previously communicated birth preferences, forcibly removing the placenta, administering medication you didn't request, or performing any procedures without your consent before, during or after labor?
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CONNECTION AND FLOW - Which of these points below describes your experience best?
I felt that I could disconnect my mind and fully connect with my body
I experienced a sense of complete surrender to the process
I felt like I was in a trance or meditative state
I was able to flow with the waves of contractions without resistance
I felt a deep connection with my baby as they were being born
I felt strong and powerful in every phase of labor.
I felt that my body knew exactly what to do
I didn't feel that I could disconnect my mind nor connect with my baby while being born
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ENVIRONMENT AND DISTRACTIONS - Which of these points below describes your experience best?
There was too much movement and distraction around me, making it hard to focus.
I felt watched, and that affected my ability to relax
The lighting, noises, or energy of the place made me uncomfortable
I did not feel safe in the space where I gave birth
I felt completely supported and held by my environment
I was able to create the atmosphere I desired for my birth
Otro
PAIN AND SENSATION MANAGEMENT - Which of these points below describes your experience best?
I felt intense pain, but I managed it with breathing and focus
The pain overwhelmed me, and I felt like I lost control.
I experienced fear or panic at some point
I felt that each contraction brought me closer to meeting my baby
I lost track of time and immersed myself in the experience
I screamed, vocalized, or made instinctive sounds to release the intensity
I felt pleasure or even ecstasy at some point during labor
Otro
MIND AND EMOTIONS - Which of these points below describes your experience best?
My mind interfered, and I struggled to let go of control
I surrendered to the experience without questioning anything
I had moments of doubt about whether I could do it
I felt that my body was stronger than I had imagined
I experienced moments of deep gratitude and emotion
I felt that my mindset was key to my birth experience
My fear faded as labor progressed.
Otro
RELATIONSHIP WITH THE SUPPORT TEAM - Which of these points below describes your experience best?
I felt held and supported by those who accompanied me.
I did not feel heard or respected in my decisions.
My partner or companion was essential for my confidence.
I felt alone or disconnected from those present
My midwife/doula/doctor provided me with the security I needed.
Otro
Did you experience a home birth?
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Yes
No
If it wasn't at home, where was it?
In the end, was the experience mostly how you envisioned it?
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Yes
Mostly yes
Not really, but it turned out better
Not really, it turned out a bit different
Not at all
How would you rate your experience?
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TRAUMATIZING
1
2
3
4
5
6
7
8
9
INCREDIBLE
10
1 is TRAUMATIZING, 10 is INCREDIBLE
Please share your birth experience in your own words. You can include how you felt at each stage, what emotions predominated, how you managed the pain or sensations, if there was any key moment you remember, and how you experienced the connection with your body and your baby. You can also describe the environment, the people who accompanied you, and any other details you think are important. If you're unsure where to start, you can answer these questions: How did your labor begin? What thoughts and emotions did you have at each stage? How did you manage the pain or contractions? Did you feel it was a long labor, or did it fly by? How was the moment of birth? How did you feel immediately after giving birth?
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How many hours were you in labor for? (Starting from when you first noticed contractions/ruptured water bag/etc.)
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What aspects of the birth do you think impacted most on your final experience (mind, body, surroundings, support)? And why:
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What type of thoughts and emotions did you experience during labor?
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Was there a special technique you used during labor to manage the sensations and thoughts (breathing, visualization, affirmations, etc)?
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SECOND CHILDBIRTH EXPERIENCE (in case you have more than 1 birth experience)
What ended up being your SECOND childbirth experience?
Natural birth in hospital
Humanized birth in hospital
C-section
Natural home birth
Natural home birth in bath tub
Medicated birth
Un-medicated birth
Other
How would you rate your experience?
TRAUMATIZING
1
2
3
4
5
6
7
8
9
INCREDIBLE
10
1 is TRAUMATIZING, 10 is INCREDIBLE
What did you do different this time (during pregnancy and birth) ? How has your first child birth experience impacted your second experience?
Please share your birth experience in your own words. You can include how you felt at each stage, what emotions predominated, how you managed the pain or sensations, if there was any key moment you remember, and how you experienced the connection with your body and your baby. You can also describe the environment, the people who accompanied you, and any other details you think are important. If you're unsure where to start, you can answer these questions: How did your labor begin? What thoughts and emotions did you have at each stage? How did you manage the pain or contractions? Did you feel it was a long labor, or did it fly by? How was the moment of birth? How did you feel immediately after giving birth?
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Reflection
After experiencing your birth, do you feel the same about the need for a doctor, or has your perception changed?
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Was there something, looking back on the experience, that you would have loved to know beforehand or do different?
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How has your perception on childbirth changed after your experience?
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Has your perception on mental strength changed after experiencing childbirth?
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Do you believe that the mental preparation for childbirth is equally or more important than the physical preparation?
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How would you rate your postpartum experience
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TRAUMATIZING
1
2
3
4
5
6
7
8
9
INCREDIBLE
10
1 is TRAUMATIZING, 10 is INCREDIBLE
How did you experience postpartum?
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If you had to describe the whole experience in 2 words what would they be?
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What message would you share with other woman who are considering to have children?
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THANK YOU SO MUCH!!
Thank you so much for taking the time to fill out this questionnaire!
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