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Jersey Maternity Voices Feedback
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1.
Question 1.
In what capacity did you interact with Maternity Services?
Required
- Required.
Service User
Partner of Service User
Family member
Other healthcare professional
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2.
Question 2.
Which department(s) or service(s) would you like to provide feedback on?
Required
- Required.
Assisted Reproduction Unit
Antenatal Clinic (Hospital)
Community Midwife Team
GP
Labour Ward
SCBU
Maternity Ward
Health Visitor
Gynaecology Department
Breast feeding support
Other
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3.
Question 3.
When does your feedback relate to?
Required
- Required.
2024
2023
2022
4.
Question 4.
What is your ethnicity
White
British
Irish
Polish
Portuguese
Other
Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background
Mixed
White and Black Caribbean
White and black African
White and Asian
Any other mixed background
Black or Black British
Caribbean
African
Any other black background
Other Ethnic Group
Chinese
Any other Ethnic Group
I do not wish to disclose my ethnic origin
5.
Question 5.
Is English your first language?
Yes
No
6.
Question 6.
What is your sex?
Male
Female
Other
Prefer not to say
7.
Question 7.
What is your sexual orientation?
Heterosexual (straight)
Same sex relationship (female)
Same sex relationship (male)
Mixed sex (trans/non-binary/gender non conforming)
Rather not say
8.
Question 8.
How old are you?
17 or younger
18-20
21-29
30-39
40-49
50-59
60 or older
9.
Question 9.
What is your marital status?
Single
Married or domestic partnership
Divorced
Separated
Widowed
10.
Question 10.
What is your household income?
Less than £10,000
£10,000 to £19,999
£20,000 to £29,999
£30,000 to £39,999
£40,000 to £49,999
£50,000 to £59,999
£60,000 to £69,999
£70,000 to £79,999
£80,000 to £89,999
£90,000 to £99,999
£100,000 to £149,999
£150,000 or more
11.
Question 11.
How did you hear about Jersey Maternity Voices?
Leaflet from booking in pack/ Health Visitor pack
Poster in Maternity/other setting
From my midwife/ HV/ GP/ other service provider
Social media
Word of mouth
Hypnobirthing/NCT/Babysteps
This is the first time I have heard of you
Other (please specify):
This is required
Input box for - Other (please specify):
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12.
Question 12.
Please tell us about your experience with maternity services in Jersey (this includes pre-conception, pregnancy, labour, birth, after-care, and the 4th trimester, including Health Visitors)
Required
- Required.
13.
Question 13.
What was good about your experience? (this may include positive feedback about specific midwives or consultants, comments about the facilities, additional support you may have had for example perinatal mental health support/breastfeeding support, how you were communicated with etc)
14.
Question 14.
What was not so good about your experience?
15.
Question 15.
What could have been done differently to improve your experience? What changes would you like to see?