Pregnancy Support Quizπ
What Support would benefit me?
This quiz is a guide to help you understand what supportive services might benefit you. HAVE FUN!π€
Name
*
First Name
Last Name
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Email
*
example@example.com
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Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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1. Are you currently pregnant?
*
Yes
Not sure yet
No
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2. How supported do you feel by those around you?
No support
Some, not enough
Completely Supported
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3. Was this pregnancy planned?
Type a question
completely a surprise!
I knew it was a possibility, but it was still a shock!
It was planned!
Other
If other, please expound
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4. How did you feel when you found out you were pregnant?
Pick as many as you want
π€¨π³π―π€―
βΊοΈπ€π₯°πππ½
π£πππ
π« π« π« π«
π€―π€―π€―π€―
Pick as many as you want
Shocked
nervous
Excited
Scared
Hopeful
Ecstatic/overjoyed
Unsure/denial
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5. What are you considering?
Type a question
Parenting
Adoption
Temporary Place for my baby
Abortion
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6. How Prepared do you feel for this journey of Pregnancy & Childbirth?
1- not at all prepared! 10- completely confident!
1
2
3
4
5
6
7
8
9
10
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7. What do you find yourself thinking about most?
you can pick as many as you want
Just getting through day by day
Wondering "is this normal during pregnancy?"
Daydreaming about when baby is here
What Birth will be like & how to get ready for that
How do I take care of a little human?π³
How to take care of myself after birth
Finding my people [village]πͺπ½
How to stay my healthiest during pregnancyπππ₯π
Other
Add anything we left outπ
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8. What's been your favorite things to do recently?
Type your answer below
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Use one word or emoji...
To describe your pregnancy experience so far...
Now describe what you want your experience to be from now on
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Before you answer this last question, I want you to remember one thing: You don't have to have everything figured out yet and you don't have to have all the answers. Just pick whatever you feel relates to you. We got this [together]πͺπ½
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10. Fill in the blank "I could use support in..."
Pick as many as you need. You can always change your answers laterπ
Someone to go to during pregnancy to answer my questions and just to know someone is here for me
Help with self-care/physical health
Preparing for giving birthπ€°π½
Someone to support me DURING birth
Help my partner get ready for birth/parenting
Helping my other kids prepare for a new baby
Nutritionπ π₯
housing support
Financial Support
Information about Adoption
Finding a Community "A Village of support"
Caring for a newborn baby & Parenting Classes
Help getting baby items and supplies
Breastfeeding support
Postpartum support [after birth]
Mental Health Support
I'm considering Abortion and would like to talk to someone about it
Other
Put your BIGGEST NEED here & anything else you'd like to add
Submit
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