Childbirth Outcomes Survey

Please answer the questions for each of your pregnancies, excluding pregnancies that ended with miscarriage. Thank you for your time and interest in helping to find a cause for the increase in birth defects.

Question Title

* 1. Pregnancy #1
What was the age you conceived?

Under 18 years

18-21 years

22-29 years

30-36 years

37-42 years

Over 42 years

Question Title

* 2. Was your pregnancy covered by insurance?

Yes

No

Not sure

Question Title

* 3. Pregnancy #1
Did you have ultrasound while pregnant?

Yes

No