2017 Parent ACCESS to care Questions STEPHENSON COUNTY

The All Our Kids Network is trying to find out how to help pregnant moms have healthy children. This is a PRIVATE survey - no one will know who filled it out. Please be honest so we can get the best answers possible and work to find solutions to help pregnant moms.

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* 1. Please check all of the boxes that apply to you.

I was pregnant as a teenager.

I did not receive prenatal care during the first trimester first 12 weeks) of my pregnancy.

I smoked while I was pregnant.

I used drugs or alcohol while I was pregnant.

I did not have any of these problems.

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* 2. Please select the problem that was the BIGGEST for you during your pregnancy:

I was pregnant as a teenager

I did NOT receive prenatal care during the first trimester of my pregnancy

I smoked cigarettes while I was pregnant

I used drugs or alcohol while I was pregnant

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* 3. Have you ever tried to find help for this problem?

Yes

2017 Parent ACCESS to care Questions STEPHENSON COUNTY

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* 1. Please check all of the boxes that apply to you.

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* 2. Please select the problem that was the BIGGEST for you during your pregnancy:

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* 3. Have you ever tried to find help for this problem?

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* 4. What challenges or barriers, if any, have you experienced as you tried to get help?

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* 5. What type of help would be most helpful to you to deal with the problem?

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* 6. If you did try to find help for this problem, were you satisfied with the help you received?