Mother: Miscarriage at Home with a Baby of Less than 10 Weeks Gestation

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* 1. Did your baby die when it was younger than ten weeks?

Yes

If your baby was older than 10 weeks when you miscarried, there is a different survey than this to answer.

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* 2. How many weeks pregnant were you when you found out that the baby died?

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* 3. How many weeks gestation was the baby when it passed away?

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* 4. Did your doctor or nurse explain to you why the baby was still inside of you after it died? (Please check any that apply)

Yes

I would have appreciated an explanation of why the baby was still inside of me.

I did not care to know why I was still carrying my baby even though he/she died.

Yes, but only after I asked.

I don’t remember

Other

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* 5. How did you find out that the baby died? (Please check any that apply)

I found out there was no heartbeat at the doctor’s office.

I found out there was no heartbeat at my regular ultrasound.

They found no heartbeat at the doctor’s office and confirmed the baby had died with an ultrasound.

They found no heartbeat at the midwife visit and confirmed the baby had died with an ultrasound.

I went to the emergency room and found out my baby had died.

I began to miscarry at home without any idea that my baby had died.

Other

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* 6. If you had an ultrasound, please check any that apply to your ultrasound experience.

I did not have an ultrasound.

I could see that there was no heartbeat.

The ultrasound tech said there was no heartbeat.

The ultrasound tech looked concerned.

The ultrasound tech was cold.

The ultrasound tech was kind and empathetic.

The ultrasound tech hinted that there may be a problem.

The ultrasound tech gave me no indication that there may be a problem.

None of these apply to my experience.

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* 7. Please check all that apply to your experience of finding out from your doctor that the baby had died. (Please check any that apply)

I could see that there was no heartbeat.

The doctor said there was no heartbeat.

The doctor told me the baby had died.

The doctor looked concerned.

The doctor was cold.

The doctor was kind and empathetic.

The doctor told me in person that the baby had died.

The doctor told me over the phone that the baby had died.

The doctor did the ultrasound and said there was no heartbeat.

None of these apply to my experience.

Other

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* 8. What term did the doctor use when referring to the baby’s death? (Please check any that apply)

Miscarriage

Stillbirth

Preemie death

Infant death

Spontaneous abortion

I do not recall what term the doctor used

Other

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* 9. What term did the doctor use when referring to your baby? (Please check any that apply)

The doctor referred to my baby as a baby

The doctor referred to my baby as a fetus

The doctor referred to my baby as tissue

The doctor called my baby by his/her name

Other

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* 10. Were you given information to make a choice on miscarriage at home versus hospital procedure? (Please check any that apply)

Yes

I was not offered the opportunity to make any decisions.

I was not able to make any decisions.

Other

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* 11. Would you have liked to have received a miscarriage kit to take home that would include a colander to catch the baby, picture of what the baby would look like, a vessel to place the baby in, and written instructions for home miscarriage?

Yes, and I did receive a miscarriage kit

Yes, but I did not receive a miscarriage kit

No, but I was offered a miscarriage kit

No and I did not want a miscarriage kit

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* 12. Were you given information on how the miscarriage would progress? (Please check any that apply)

I was told I would have cramping

I was told I would have bleeding

I was told I would possibly have labor type pains coming and going

I was not given any information

I would like to have received more verbal information.

I would like to have received more written information.

I do not remember if anyone did or did not inform me on what to expect and choices I could make.

I would have appreciated a repeat of the information

I was told a Loss Doula could be available to me.

I was able to have a Loss Doula at my birth.

The medical staff at the doctor's office explained in detail what would be happening.

The information offered was verbal.

The information offered was written.

I had been through this before so I did not need much information.

I would have preferred more information.

I would have preferred to be less informed.

I don’t remember

Other

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