This survey is intended to gain an understanding of young women's perceptions of childbirth and to understand what they already know, or would like to know more about.  The information attained here will help to create a method for reaching out to and educating young women about birth in a way that is most accessible and preferable to this age group.

ELIGIBILITY:
To participate in this survey, you must be a female between the ages of 18 and 26.
Please feel free to forward to anyone who meets these requirements.

* 1. How old are you?

* 2. What is your motherhood status?

* 3. When it comes to pregnancy and childbirth, I:

  Know nothing about this Don't know much about this Feel well-educated about this Wish I knew more about this
Pregnancy
How a baby grows
Vaginal Birth
Cesarean Section (C-Section)
Epidural
Doula
Midwife

* 4. What I know about pregnancy and childbirth I have learned from:

  Strongly Agree Somewhat Agree Somewhat Disagree Strongly Disagree I don't know Not Applicable
A college class
A non-college class
A middle school class
A high school class
TV sit-coms or dramas
TV reality shows
Movies
Books - fiction/novels
Books - nonfiction, pregnancy books
My mother
My sister
My friend(s)
My father
My brother
My boyfriend
Other family member
From going through it myself
The internet
A midwife
An OB/GYN doctor (obstetrics)
A doula

* 5. From people in your life, please rate the following:

  Yes No I don't know or Not Applicable
I have heard positive stories about being pregnant
I have heard negative stories about being pregnant
Someone I know has had a vaginal birth
I have heard positive stories about vaginal birth
I have heard negative stories about vaginal birth
Someone I know has had a C-Section
I have heard positive stories about C-Section
I have heard negative stories about C-Section
I know someone who has used an epidural in birth
I know someone who has had an un-medicated (natural) birth

* 6. Have you seen a TV show, DVD or movie showing any of the following:

  Yes No Not sure/Don't remember
A vaginal birth
A birth without an epidural (medication to numb from waist down)
An emergency birth
The death of a mother during birth
The death of a baby during birth
A happy birth
A traumatic birth
A doula (a woman supporting a woman through labor)
A birth at home
A birth under water
A doctor saving a mother's life during birth

* 7. What are your general feelings toward pregnancy?
Please check all that apply.

* 8. What are your general feelings toward childbirth?
Please check all that apply.

* 9. How do you feel about pain medication for labor and birth?
Please check all that apply.

  Yes No
I know what an epidural is
I am certain I want an epidural for birth
I am certain I don't want an epidural for birth
I have heard positive stories about epidurals
I have heard negative stories about epidurals
There are no risks to getting an epidural
I would like to have an un-medicated (natural) birth but am open to an epidural

* 10. How do you feel about giving birth vaginally?
Please check all that apply.

  Yes No
That's definitely how I want to give birth
I don't care if I give birth vaginally or not
I am scared of a vaginal birth
I want to know what it feels like to give birth vaginally
I am grossed out by vaginal birth
A vaginal delivery is so much easier than a C-Section
My body can't do that
I am excited to push my baby out

* 11. How do you feel about Cesarean Section (C-Section, surgical delivery)?

  Yes No
That's definitely how I want to birth
I don't care if I have a C-section or not
I am scared of a C-section
I am grossed out by a C-section
A C-section is so much easier than a vaginal delivery
The risks of a C-section are minimal
I definitely do not want to have a C-Section

* 12. Have you attended a birth?

* 13. If targeted to your age-group, how likely would you be to do the following to learn about pregnancy and childbirth:

  I definitely would Maybe I would I don't know I probably would not I definitely would not
Visit an educational website
Attend a class at school
Attend a private class in my home
Attend a semi-private class with just friends I invite
Attend a Webinar or online class
Watch a DVD
Get Tweets
Read Facebook posts
Read a magazine
See a play
Hear stories from mothers
Attend discussion groups with other college-aged women

* 14. Please tell us about yourself - Please check ALL that apply:

* 15. Please indicate your highest level of education:

* 16. Please enter the zip code of the town/city where you grew up.
If you grew up outside of the United States, please provide the name of the country where you grew up in the Country Name field.

Thank you for your time and insights!
If you would like to be interviewed on this topic or if you have any questions, please contact: Leah@MothersCircle.net
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