Survey on Maternal Health

Demographics (DEM1) - Question identifier:DEM1_R01

The following questions are to determine if you are eligible to complete this survey.

Demographics (DEM1) - Question identifier:DEM1_Q05

Did you give birth between January 1, 2018 and June 30, 2018?

• 1: Yes
• 2: No

Demographics (DEM1) - Question identifier:DEM1_Q10

What is this baby's name?

Long Answer Length = 25

Demographics (DEM1) - Question identifier:DEM1_Q15

What is [your child]'s birth date?

Long Answer Length = 10

Demographics (DEM1) - Question identifier:DEM1_Q20

What is your age?

Min = 14; Max = 55

Demographics (DEM1) - Question identifier:DEM1_Q25

In which province or territory do you live?

• 10: Newfoundland and Labrador
• 11: Prince Edward Island
• 12: Nova Scotia
• 13: New Brunswick
• 24: Quebec
• 35: Ontario
• 46: Manitoba
• 47: Saskatchewan
• 48: Alberta
• 59: British Columbia
• 60: Yukon
• 61: Northwest Territories
• 62: Nunavut

Maternal Experience (EXP) - Question identifier:EXP_R01

The following questions are about your feelings and experiences in the time before and after the birth of your baby.

Maternal Experience (EXP) - Question identifier:EXP_Q05

During your pregnancy with [your child], did you attend pregnancy support programs? For example, programs where you learned about having a healthy pregnancy or caring for your baby.

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q10

Since the birth of your baby, did you attend any parenting support programs? For example, programs where you learn about caring for your child, breastfeeding support, parenting skills and infant or child development.

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q15

Since the birth of your baby, when you needed other support, how often was it available?

Would you say:

• 1: None of the time
• 2: A little of the time
• 3: Some of the time
• 4: Most of the time
• 5: All of the time

Maternal Experience (EXP) - Question identifier:EXP_Q20_1

In general, how would you rate the following?

Your physical health

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor

Maternal Experience (EXP) - Question identifier:EXP_Q20_2

In general, how would you rate the following?

Your mental health

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor

Maternal Experience (EXP) - Question identifier:EXP_Q25

How would you describe your sense of belonging to your local community?

Would you say:

• 1: Very strong
• 2: Somewhat strong
• 3: Somewhat weak
• 4: Very weak

Maternal Experience (EXP) - Question identifier:EXP_Q30

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

• 00: 0 - Very dissatisfied
• 01: 1
• 02: 2
• 03: 3
• 04: 4
• 05: 5
• 06: 6
• 07: 7
• 08: 8
• 09: 9
• 10: 10 - Very satisfied

Maternal Experience (EXP) - Question identifier:EXP_Q35_1

For each of the following statements, choose the response that comes closest to how you have been feeling in the past 7 days, not just how you feel today.

I have felt sad or miserable

• 1: Yes, most of the time
• 2: Yes, sometimes
• 3: Not very often
• 4: No, never

Maternal Experience (EXP) - Question identifier:EXP_Q35_2

For each of the following statements, choose the response that comes closest to how you have been feeling in the past 7 days, not just how you feel today.

I have been anxious or worried for no good reason

• 1: Yes, most of the time
• 2: Yes, sometimes
• 3: Not very often
• 4: No, never

Maternal Experience (EXP) - Question identifier:EXP_Q35_3

For each of the following statements, choose the response that comes closest to how you have been feeling in the past 7 days, not just how you feel today.

I have been so unhappy that I have had difficulty sleeping

• 1: Yes, most of the time
• 2: Yes, sometimes
• 3: Not very often
• 4: No, never

Maternal Experience (EXP) - Question identifier:EXP_Q35_4

For each of the following statements, choose the response that comes closest to how you have been feeling in the past 7 days, not just how you feel today.

I have blamed myself unnecessarily when things go wrong

• 1: Yes, most of the time
• 2: Yes, sometimes
• 3: Not very often
• 4: No, never

Maternal Experience (EXP) - Question identifier:EXP_Q35_5

For each of the following statements, choose the response that comes closest to how you have been feeling in the past 7 days, not just how you feel today.

I have looked forward with enjoyment to things

• 1: Yes, most of the time
• 2: Yes, sometimes
• 3: Not very often
• 4: No, never

Maternal Experience (EXP) - Question identifier:EXP_Q40

In the past 2 weeks, how often have you been bothered by feeling nervous, anxious or on edge?

Would you say:

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Every day or nearly every day

Maternal Experience (EXP) - Question identifier:EXP_Q45

In the past 2 weeks, how often have you been bothered by not being able to stop or control worrying?

Would you say:

• 1: Not at all
• 2: Several days
• 3: More than half the days
• 4: Every day or nearly every day

Maternal Experience (EXP) - Question identifier:EXP_Q50

Since the birth of [your child], has the thought of harming yourself occurred to you?

Would you say:

• 1: Yes, quite often
• 2: Sometimes
• 3: Hardly ever
• 4: Never

Maternal Experience (EXP) - Question identifier:EXP_Q55

Since the birth of your baby, did you ever feel so sad, miserable or anxious that you were concerned about your emotions or mental health?

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q60

At these times, when you were concerned about your emotions or mental health, did you talk to anyone?

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q65

Was it:

• 1: Family doctor, midwife, or nurse
• 2: Psychiatrist, psychologist, social worker, or counsellor
• 3: Spouse or partner
• 4: Family or friend
• 5: Someone else

Maternal Experience (EXP) - Question identifier:EXP_Q70

Has a doctor, midwife, nurse or other health care worker ever told you that you had depression or a mood disorder?

Would you say:

• 1: Yes, before you were pregnant with [your child]
• 2: Yes, while you were pregnant with [your child]
• 3: Yes, since the birth of [your child]
• 4: No

Maternal Experience (EXP) - Question identifier:EXP_Q75

Since the birth of your baby, have you received treatment for your emotions or mental health?

Would you say:

• 1: Yes, medication, such as antidepressants
• 2: Yes, counselling, such as talk therapy
• 3: Yes, medication and counselling
• 4: No

Maternal Experience (EXP) - Question identifier:EXP_Q80

After you learned you were pregnant with [your child], did you use any of the following?

Cannabis (medical or non-medical) during the pregnancy

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q85

After you learned you were pregnant with this baby, did you use any of the following?

Opioids (medical or non-medical) during the pregnancy

• 1: Yes
• 2: No

Maternal Experience (EXP) - Question identifier:EXP_Q90

While you were breastfeeding [your child], did you use cannabis?

• 1: Yes
• 2: No
• 3: Did not breastfeed

Demographics (DEM2) - Question identifier:DEM2_Q05

What is your marital status?

Is it:

• 1: Married
• 2: Living common law (Two people who live together as a couple but who are not legally married to each other.)
• 3: Never married (not living common law)
• 4: Separated (not living common law)
• 5: Divorced (not living common law)
• 6: Widowed (not living common law)

Demographics (DEM2) - Question identifier:DEM2_Q10

What is the highest certificate, diploma or degree that you have completed?

• 1: Less than high school diploma or its equivalent
• 2: High school diploma or a high school equivalency certificate
• 3: Trades certificate or diploma
• 4: College, CEGEP or other non-university certificate or diploma (Exclude trades certificates or diplomas.)
• 5: University certificate or diploma below the bachelor's level
• 6: Bachelor's degree (e.g., B.A, B.A. (hons), B. Sc., B.Ed., LL.B.)
• 7: University certificate, diploma, or degree above the bachelor's level