Expectations and Satisfaction With Prenatal Care
Thank you for logging on to the survey of expectations and satisfaction with prenatal care.
1.
Please tell us a little about yourself.
How old are you?
2.
What is your race?
American Indian or Alaskan Native
Asian or Pacific Islander
Black
Hispanic or Latino
White
Some other race
3.
What is your highest level of grade completion?
Less than 9th grade.
9th - 12th grade (no diploma)
High School Graduate (includes GED)
Some college (no degree)
Associate Degree
Bachelor's degree
Graduate or Professionl Degree
4.
What is your pregnancy history?
Total # of times pregnant
Total # of pregnancies that lasted more then 35 weeks (term)
Total # of pregnancies that lasted between 20 and 35 weeks (premature)
Total # of pregnancies that lasted less than 20 weeks (miscarriage/abortion)
Total # of living children
5.
Tell us about your most recent pregnancy
Did you receive prenatal care?
How many weeks pregnant were you when you had your first prenatal care visit?
Approximately how many prenatal care visits did you have?
Was this baby born between 36 and 40 weeks or before 36 weeks?
Who did your prenatal care (a physician, a nurse-midwife, a midwife, or someone else)?
What, if any, complications did you have during this most recent pregnancy?
What is the date this child was born (month, day, year)
Thinking back to your most recent pregnancy, please rate the following in terms of your expectations during prenatal care.
6.
I expected to be seen sooner for my first prenatel visit.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
7.
I expected for my prenatal visits to take a long time.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
8.
I expected to get more from my prenatal visits than being weighed and having my baby's heart checked.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
9.
I expected to receive information during my visits without having to ask so many questions.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
10.
I expected to have one provider (physician/nurse-midwife/midwife) that I would routinely see for my prenatal visits.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
11.
I expected that the provider that I routinely saw for prenatal care would deliver my baby.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
12.
I expected my provider to care about how I felt mentally as well as physically.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
13.
I expected my provider to be gentle during my physical exams.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
14.
I expected someone in the office/clinic to listen to my problems.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
15.
I expected a referral when I told someone in the office/clinic about a problem.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
16.
I expected the services of a social worker to be part of prenatal care.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
17.
I expected the services of a nutritionist to be part of my prenatal care.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
Thinking back to your most recent pregnancy, please sate the following in terms of your satisfaction with your prenatal care.
18.
I was satisfied with the services of a public health nurse as part of prenatal care.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
19.
I was satisfied with the explanation my provider gave to me about what was going to happen during my prenatal care visits.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
20.
I was satisfied with the explanation my provider gave to me about medical procedures.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
21.
I was satisfied with the information my provider gave to me about how things were going with my pregnancy.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
22.
I was satisfied with the kinds of things my provider discussed with me during my prenatal visits.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
23.
I was satisfied with the explanation my provider gave to me about what I could expect about parenting a newborn.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
24.
I was satisfied with the way my provider prepared me for labor and delivery.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
25.
I was satisfied with the way my provider treated me during my pregnancy.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
26.
I was satisfied with the respect that I was shown by my provider.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
27.
I was satisfied with the quality of care I received from my provider.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
28.
I was satisfied with the way I was not meant to feel I was wasting my provider's time.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
29.
I was satisfied with being able to ask questions without embarrassment.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
30.
I was satisfied with not having to repeat my story every time I came in for a visit.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
31.
I was satisfied with the way the staff expressed concern about my overall personal situation.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
32.
I was satisfied with the time the staff spent talking about things of interest to me.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
33.
I was satisfied with the way the staff treated me.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
34.
I was satisfied with the time the staff took with me, even though I did not have problems with this pregnancy.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
35.
I was satisfied with the interest and concern the staff showed me.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
36.
I was satisfied with the way the staff dealt with all my medical problems.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
37.
I was satisfied with the amount of time I waited in the office/clinic to be seen by my provider.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
38.
I was satisfied with the total amount of time I spent in the office/clinic.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
39.
I was satisfied with the parking facilities at the office/clinic.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
40.
I was satisfied with the waiting room facilities at the office/clinic.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
41.
I was satisfied with the examination rooms at the office/clinic.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
42.
I was satisfied with my ability to schedule prenatal visits at a time that was convenient for me.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
43.
I was satisfied with how easy it was to reschedule my prental visits when I needed to.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
44.
I was satisfied with how easy it was to get my first prenatal visit early in my pregnancy (that is, before the 4th month).
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
45.
I was satisfied with having all the recommended tests.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
46.
I was satisfied with the number of prenatal visits during the fist 6 to 7 months of my pregnancy.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
Not applicable
Please answer each of the following questions. Please be as complete and descriptive a possible.
47.
What, if anything, would you have liked to have occurred, but was not provided in your most recent prenatal care experience?
48.
What, if anything, was provided in your prenatal care experience that you believe was unnecessary?
49.
Identify things that you liked most about the prenatal care you received.
50.
Identify things that you liked least or found bothersome about the prenatal care you received.
Thank you so much for participating in this survey.
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