Protecting the mamatotos. Help us understand how the corona pandemic is affecting pregnant women in Australia.
In an uncertain time, pausing to consider your concerns can be difficult.
If you become overwhelmed while completing this questionnaire please stop and seek support from your midwife, doula or care provider, or call:
PANDA National Helpline (Mon to Fri, 9am - 7.30pm AEST/AEDT): 1300 726 306
Pregnancy, Birth and Baby: 1800 882 436
Sign in to Google to save your progress. Learn more
How concerned are you that your pregnancy and birth will be impacted by the coronavirus pandemic?
Clear selection
What are you most concerned about in terms of being pregnant and birthing your baby during the global coronavirus pandemic?
Clear selection
Prior to the C-19 pandemic, what type of birth were you planning?
Clear selection
How likely do you think you are to have the birth you’ve planned?
I do not think I will be able to have the birth I planned
I am confident I can continue with my birth plan
Clear selection
What steps have you been able to take to prepare for birth in the current climate?
What changes in birth plan, support or additional services do you think you will need to birth safely during the corona pandemic, if any?
Clear selection
Could you share any more details about how you feel about pregnancy, birth and motherhood in the present time?
How old are you?
Clear selection
What is your approximate average household income?
Clear selection
Please enter your postcode:
Do you identify as Aboriginal and/or Torres Strait Islander?
Clear selection
If you'd like to find out more about support for birthing women during the COVID-19 crisis, or you'd like to tell us more about your situation, please leave your best contact details.
Thank you. Your answers will help other women and babies.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Apparent Communications Pty Ltd. Report Abuse