Inova BabyNET 2009 After Delivery Survey
 
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  BabyNET Pregnancy: After Delivery Survey  
Congratulations, the big day has come! We know you are busy, so we'll keep this short. Please let us know how it went.


 
1.
*
 
 
 
 
2.
Were you enrolled in the Inova BabyNET Pregnancy program?*
 Do not include participation in the Inova BabyNET Lactation program.
 
 
 
 
3.
*
  mm/dd/yyyy
 
 
 
4.
*
 Please enter the number of weeks, rounded to the nearest week (eg, 39 weeks, 40 weeks, etc.)
 
 
 
 
5.
What did your baby(ies) weigh at birth?*
 Please enter weight in pounds and ounces. Count only your most recent birth, not previous children.
 

 

 

 

 

 
 
 
 
6.
Were any of your baby(ies) admitted to the intensive care unit? (Neonatal ICU or NICU)*
 Please count only your most recent birth, not previous children.
 
 
 
 
7.
If your baby(ies) did stay in the NICU, please list the number of days for each baby.*
 If you are usings weeks or months, please indicate that in the text box with the number.
 

 

 

 

 
 
 
 
8.
How did you deliver?*
 
 
 
 
 
9.
*
 
 
 
 
10.
How many days did your baby(ies) stay in the hospital after delivery (not counting NICU days)?*
 

 

 

 

 

 
 
 
 
11.
Are you planning to breastfeed your new baby(ies)?*
 Check yes if you are planning to use breastfeeding, either exclusively or partially for your new baby(ies).
 
 
 
 
12.
Did you have any complications or medically risky conditions during your pregnancy*
 
 
 
       
 
 
 
13.
Did you smoke during your pregnancy?*
 
 
 
 
 
 
14.
Were you put on bedrest by your doctor or other health care provider at any point in your pregnancy?*
 
 
 
 
15.
While pregnant, was your activity reduced or restricted in any way by your doctor or other health care provider?*
 
 
 
 
16.

 
 
 
 
17.
How satisfied were you with the way the birth went?*
 
 
 
 
 
 
 
 
18.

 
 
 
 
19.
How prepared did you feel for the birth?*
 
 
 
 
 
 
 
 
20.

 
 
 
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