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New Mothers Survey

The New Mothers Survey is a survey that collects data on the health and well-being of mothers and their infants.

Time to complete

2 minutes

Eligibility

To be eligible to participate in the New Mothers Survey, a mother must have given birth to a live infant within the past 12 months.

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Questions for New Mothers Survey

1.

Are you a mother?

The answer should be a single choice:
  1. Yes
  2. No
2.

If yes, how many children do you have?

The answer should be a text input.
3.

How old are you?

The answer should be a single choice:
  1. Under 18
  2. 18-24 years old
  3. 25-34 years old
  4. 35-44 years old
  5. 45-54 years old
  6. Over 55
4.

What is your highest level of education?

The answer should be a single choice:
  1. Less than a high school diploma
  2. High school degree or equivalent
  3. Bachelor's degree
  4. Master's degree
  5. Doctorate
5.

Are you employed?

The answer should be a single choice:
  1. Yes
  2. No
6.

If yes, what is your occupation?

The answer should be a single choice:
    7.

    How many hours do you work per week?

    The answer should be a single choice:
    1. < 10 hours
    2. 10 to 20 hours
    3. 20 to 30 hours
    4. 40 hours
    5. > 40 horus
    8.

    Do you have health insurance?

    The answer should be a single choice:
    1. Yes
    2. No
    9.

    What is your annual income?

    The answer should be a number input.
    10.

    Where do you live?

    The answer should be a country.
    11.

    Do you have a place to live that is safe and clean?

    The answer should be a single choice:
    1. Yes
    2. No
    12.

    Do you have enough food to eat?

    The answer should be a single choice:
    1. Yes
    2. No
    13.

    Do you have transportation to get the medical care you need?

    The answer should be a single choice:
    1. Yes
    2. No
    14.

    Do you have someone you can talk to about your problems?

    The answer should be a single choice:
    1. Yes
    2. No
    15.

    Do you feel like you are a good mother?

    The answer should be a single choice:
    1. Yes
    2. No
    16.

    Do you feel like you are doing a good job taking care of your children?

    The answer should be a single choice:
    1. Yes
    2. No
    17.

    Do you feel like you have enough time for your children?

    The answer should be a single choice:
    1. Yes
    2. No
    18.

    Do you feel like you have enough time for yourself?

    The answer should be a single choice:
    1. Yes
    2. No
    19.

    Do you feel like your children are healthy?

    The answer should be a single choice:
    1. Yes
    2. No
    20.

    Do you feel like your children are happy?

    The answer should be a single choice:
    1. Yes
    2. No

    Similar Ideas

    • New Parents Survey
    • New Families Survey
    • Newborns Survey
    • Infants Survey
    • Babies Survey

    Here are some FAQs and additional information
    on     New Mothers Survey

    How long does it take to fill out the New Mothers Survey?

    The survey should take no longer than 10 minutes to complete.

    How do I know if I am eligible to participate in the New Mothers Survey?

    You may be eligible to participate in the survey if you have given birth to a child within the past 12 months.

    How will my information be used?

    Your information will be used to help researchers understand the needs and experiences of new mothers.

    Will my information be kept confidential?

    Yes. Your information will be kept confidential and will only be used for research purposes.

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