Maternal Infant Services Network (MISN) is collecting information about pregnancy and birthing experiences from women like yourselves who are residents of the Port Jervis (and surrounding) community. All of the information is anonymous, unless you would like to provide us with contact information. Please feel free to share the link with any of your friends and family who might be interested. If you would like more information about MISN or about this project, please email me at ssosnowski@misn-ny.org, and I will be happy to help.
Regards,
Stephanie Sosnowski
Deputy Director

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* 1. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 2. How many children do you have?

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* 3. How old is your youngest child?

For all of the following questions, please refer to your experiences with your youngest child.

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* 4. When you were pregnant, how did you choose your doctor?

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* 5. Did the hospital where your doctor delivered influence your decision?

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* 6. In which hospital was your most recent baby born?

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* 7. Would you choose to have another baby where your last one was born?

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* 8. If yes, why would you choose to go to the same hospital?

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* 9. If no, why wouldn't you choose to go back to the same hospital?

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* 10. In your most recent pregnancy, when was your first prenatal visit? (how many weeks pregnant were you?)

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* 11. Thinking about your most recent pregnancy, were you able to get to all of your prenatal visits?

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* 12. If you couldn't make all of your prenatal visits, why not?

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* 13. What have you heard about Bon Secours Hospital closing its maternity ward?

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* 14. How do you feel about the hospital closing its maternity ward?

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* 15. In your opinion, what do Port Jervis women need for a positive experience while pregnant?

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* 16. What would give women a good birthing experience, in your opinion?

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* 17. Is there anything else that you would like to share with us?

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* 18. Did you know that Maternal Infant Services Network offers free childbirth education classes in Port Jervis?

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* 19. Did you know that Maternal Infant Services Network can help you sign up for Medicaid for pregnancy, Child Health Plus and Family Health Plus?

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* 20. I would like to be contacted by a representative from MISN because I have a question about:

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* 21. My name is

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* 22. My email address is:

Thank you so much for your help with this project! Please visit our website at www.misn-ny.org to learn more about us!

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