Miscarriage Survey
Please select the ones applicable to you.
Rows
Yes
No
How many times
Have you ever had a patient who was experiencing a miscarriage?
1
2
Have you ever had a patient who was experiencing a stillbirth?
3
4
Have you been present at a stillbirth delivery?
5
6
Have you been present at a miscarriage delivery?
7
8
Have you performed a D & C on a woman experiencing a pregnancy loss?
9
10
Do you believe that you get enough information about pregnancy loss in your medical training?
Yes for stillbirth
No for stillbirth
Yes for miscarriage
No for miscarriage
Do you have any comments/suggestions for this?
Please rate how much do you feel stress or tired when dealing with stillbirth as a doctor
None
1
2
3
4
Very
5
1 is None, 5 is Very
Please rate how much do you feel stress or tired when dealing with miscarriage as a doctor
None
1
2
3
4
Very
5
1 is None, 5 is Very
Please select how much you agree or disagree with each statements about your staff.
Rows
Totally Agree
Somewhat Agree
Somewhat Disagree
Totally Disagree
Not applicable
My staff is well trained in assisting my patients' emotional and physical needs after STILLBIRTH.
11
12
13
14
15
My staff is well trained in assisting my patients' emotional and physical needs after MISCARRIAGE.
16
17
18
19
20
My staff is well trained in helping your patients, who are experiencing a D & C surgery, to deal with the emotional and physical effects of pregnancy loss.
21
22
23
24
25
What would be your recommendation(s) to women who have had a miscarriage?
Surgery (for example: D & C)
Home miscarriage delivery
I prefer to let them decide without swaying them in any direction
Other
What would you recommend, to your patients who have experienced a stillbirth, pertaining to autopsy of the baby?
Autopsy of the baby.
Testing of the cord and placenta.
Not have an autopsy.
Not make any recommendations.
Other
What would you recommend, to your patients who have experienced a miscarriage, pertaining to autopsy of the fetus/baby?
Autopsy of the baby.
Testing of the cord and placenta.
Not have an autopsy.
Not make any recommendations.
Other
What would you recommend, to your patients who recover their baby/fetus after delivery?
Burial
Cremation
Hospital disposition
Not make recommendations
Other
Does your state have any laws regarding the disposition of a miscarriage baby?
Yes
No
Not sure
If you have any suggestions about how pregnancy loss is handled, please write here
Please write here if you have any other comments that you would like to share for this survey
How many years do you work as a doctor?
Please write your email address if you want to get the survey results
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