Questionnaire for Stillborn Mommies

 

I’d like to gather information from other women who have went through or are going through stillbirth. I wasn’t able to find any good information when I went through the loss of my son, and I believe it would be helpful to everyone who has experienced stillbirth and does experience stillbirth to be able to relate to others who are going through the same traumatic experience. I know my answers to these questions, but I want to know your answers. The one thing I was extremely motivated towards after I lost my son was to prevent other Moms from losing their babies and to help other Moms get through stillbirth with more resources than I had. The missing aspect in all of my experience was information… there were so many unanswered questions that made my life feel like hell. I hope you will take the time to answer as many questions as you’re personally able to and I will compile all of the information and update it on my blog as I receive more completed questionnaires. If you’d like to anonymously comment your answers, that will work. If you prefer to email your answers to me, please email this completed questionnaire to info@stillbornmommy.com :).

  1. How old were you when you lost your baby to stillbirth?
    a. 15-25
    b. 26-30
    c. 31-35
    d. 36+
  2. What was the reason, if any, given for your baby being stillborn?
    a. Placental Issue (please specify)
    b. Cord Issue (please specify)
    c. Other Known Issue Prior to Stillbirth (please specify)
    d. Unknown
  3. Did you have an autopsy done on your baby? Please explain why you did or didn’t if you are up to it.
    a. Yes
    b. No
  4. Did you notice decreased fetal movement prior to your son or daughter being stillborn? Please explain if you are up to it. If not, I understand entirely.
    a. Yes
    b. No
  5. Were you completing daily kick counts prior to your baby being stillborn?
    a. Yes
    b. No
  6. Do you feel your OBGYN provided you with the best care possible?
    a. Yes
    b. No
  7. Do you feel like the outcome of your pregnancy would have been different with a better OBGYN?
    a. Yes
    b. No
  8. How far along were you when your baby was stillborn?
    a. 20-25 weeks
    b. 26-29 weeks
    c. 30-34 weeks
    d. 35+ weeks
  9. Were your nurses and doctors compassionate and empathetic with your situation?
    a. Yes
    b. No
  10. Were your nurses and doctors empathetic and compassionate during your delivery?
    a. Yes
    b. No
  11. Do you feel as if you could have done something differently to save your baby?
    a. Yes
    b. No
  12. Do you feel guilt over your baby being stillborn?
    a. Yes
    b. No
  13. Were you able to accept the fact your baby was stillborn immediately after finding out he or she was?
    a. Yes
    b. No
  14. How long did it take for you to accept your son or daughter was stillborn?
    a. 1 Week or Less
    b. 1 Week to 2 Weeks
    c. 2 Weeks to 3 Months
    d. 3 Months to 6 Months
    e. I haven’t accepted the fact my son or daughter was stillborn.
  15. Do you feel like a therapy dog would have helped you during delivery of your stillborn baby?
    a. Yes
    b. No
  16. Were your family and friends supportive of you during your stillbirth?
    a. Yes
    b. No
  17. Did you prefer your family and friends to reach out by baking you food, sending you cards and calling/texting you or did you want left alone?
    a. I appreciated family and friends reaching out.
    b. I wanted left alone.
    c. I’m not sure if I wanted them to reach out or if I wanted to be left alone.
  18. What was most traumatic for you after you delivered your stillborn baby?
    a. Holding him or her
    b. Having to bury him or her
    c. Post-Delivery Symptoms (Breast Milk leaking, yearning to hold your baby, etc.,)
    d. Having to break the news to family and/or friends
    e. Other – please explain
  19. How long has it been since your baby was stillborn?
    a. 1 Month or Less
    b. 1 Month to 6 Months
    c. 6 Months to 1 Year
    d. 1 Year to 2 Years
    e. More than 2 Years
  20. Do you want to become pregnant again?
    a. Yes
    b. No
  21. If you do want to become pregnant again, how soon after your loss are you trying? (If you did become pregnant again, how long after your loss did you become pregnant again?)
    a. Less than 3 Months
    b. 3 Months to 6 Months
    c. 6 Months to 1 Year
    d. 1 Year to 2 Years
    e. 2 Years or More
  22. If you did become pregnant again, did your next pregnancy result in a healthy, happy baby?
    a. Yes
    b. No
  23. If you did become pregnant again, did you have any conditions that made you high risk aside from a prior stillbirth? Please include details if yes.
    a. Yes
    b. No
  24. What helped you through your stillbirth more than any other factor?
  25. Who was most supportive to you throughout your traumatic experience?
  26. Was your baby’s father effected by your son or daughters stillbirth in the same way as you?
    a. Yes
    b. No
  27. Was your relationship with your baby’s father effected negatively or positively by your stillbirth?
    a. Positively (explain why/how)
    b. Negatively (explain why/how)
  28. Are you still in a relationship with your baby’s father?
    a. Yes
    b. No
    c. I wasn’t with him prior to my baby being stillborn.
  29. How did your baby’s father handle your son or daughter’s loss? Please explain.
  30. How did family support you after your son or daughter’s loss?

 

f you would like any questions added to the above questionnaire, please send me an email at admin@stillbornmommy.com

Thank you for helping other Stillborn Mommies including myself and hopefully everyone’s feedback can help others as well as ourselves!



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