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First Time Moms Beyond 35 Survey
1.
How old are you?
under 25
26-30
31-34
35-39
40-44
45-49
50-54
55+
2.
In what country do you live?
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Island
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Democratic People's Republic of Korea
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia (Federated States of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Republic of Korea
Republic of Moldova
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
State of Palestine
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Thailand
The former Yugoslav Republic of Macedonia
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United Republic of Tanzania
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Vietnam
Yemen
Zambia
Zimbabwe
3.
What is your marital status?
Single
Married
Seperated
Divorced
Widowed
Cohabitating
4.
What health conditions have you experienced?
Anemia
Anxiety
Asthma
Back pain
Blood clots
High Blood pressure
Cancer
Consitpation
Depression
Diabetes
Diarrhea
Endometriosis
Fatigue
Fibroids or Polyps
Nausea, Vomiting
Hair loss or Hair Growth
Indigestion
Infertility
Mood swings
Muscle or joint pain
Sleeping More
Sleeping Less
Stress
Thyroid
Varicose Veins
Weight Loss or Gain
None of these
Other
5.
What is your motherhood status?
Trying to conceive first baby
Want to conceive
Conceived a child/children and trying for another
Adopted a child/children
Became a mom using alternative options (i.e. ivf, surrogate, donor eggs, donor embryos)
6.
Select all communities that are important for you on your motherhood journey.
Family and friends
Online Communities
Mom Meetups
Podcasts
Others
7.
Where do you get most of your fertility information?
Friends and family
Social Media
Publications
Doctor's Office
Other
8.
How many episodes of First Time Moms Beyond 35 Podcast have you listened to?
Only 1
2-5
6-10
11-15
16-20
more than 20 episodes
9.
Would you be interested in an app that allows you to connect, share, and grow with more women at the advanced maternal age? This app would offer additional paid services with resources, games, and coaching.
Yes
No
10.
How much would you pay for the app or platform that brings together a community of women at the advanced maternal age.
Will only join the free version
$2.99/month
$4.99/month
$32/year
$57/year
up to $99/year
Current Progress,
0 of 10 answered