Ipswich and East Suffolk MVP Feedback Survey

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* 1. Where was your maternity care and/or birth?

Ipswich Hospital

Colchester Hospital

Clacton Hospital

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* 2. When was your maternity care experience - please provide month and year

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* 3. What type of birth did you have?

Spontaneous labour in hospital

Waterbirth

Home birth

Induction

VBAC

Emergency Cesarean Section

Planned Cesarean Section

Other

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* 4. Please let us know what topics you'd like to leave feedback on, general feedback is also great

Quality of maternity care

Birth choices and support

Infant feeding support

Birthing partner views

Bereavement - miscarriage, still birth and infant loss

LGBTQ+

Twins and multiples

Staff Attitude - positive

Staff Attitude - negative

Black, Asian, Minority Ethnic

English is not my first language

Refugees and asylum seekers

Mental Health

Certain religious customs to be observed

Hospital facilities

Gypsy, Roma, Traveller Communities

Induction process

Domestic violence and/or abuse victims

Physical disability

I and/or my partner have special needs

Midwife led unit - birthing centre facilities

Parking or travel issues

NNU

Maternity Triage

Other (please specify)

None of the above

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* 5. Positives - what went well

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* 6. Challenges - what could have been better

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* 7. What changes would you like to see to improve this for people in the future

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* 8. How satisfied were you with the care you received overall?

Traumatic experience of care/very poor quality of care

Poor experience of care

Improvements needed with level of care received

Expectations met with the level of care

Positive experience - pleased with the experience of care give

Traumatic experience of care/very poor quality of care

Poor experience of care

Improvements needed with level of care received

Expectations met with the level of care

Positive experience - pleased with the experience of care give

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* 9. General comments - is there any other information that would be relevant to this feedback in relation to the feedback topic you have selected?

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* 10. Diversity questions - if you would prefer not to answer the following that is ok, please just skip to the end. Who are you? Please select as applies:

Mother or birthing person

Partner of the mother or birthing person

Birth partner

Surrogate

Other

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* 11. Ethnicity

White British

Mixed - white and black Caribbean

Mixed - White and black African

Mixed - white and black Asian

Any other mixed background

Asian - British

White Irish

Any other white background

Asian - Indian

Asian - Pakistani

Asian - Banladeshi

Any other Asian background

Black - British

Black - Carribbean

Black - African

Any other black background

Chinese

Romany Gypsy

Irish Traveller

Any other ethnic group

Prefer not to say

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* 12. What is your age

17 or under

18-24

25-34

35-44

45 or over

Prefer not to say

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* 13. Please select the sexual orientation category that best represents you

Heterosexual

LGBTQ+

Prefer not to say

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* 14. What is your marital status

Single

Married

Cohabiting

Separated or divorced

Widowed

Prefer not to say

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* 15. How many children do you have

Yet to give birth

one

two

three

four or more

Prefer not to say

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* 16. Please give the first part of your post code e.g IP3, C08 etc

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* 17. How did you hear about the MVP?

Hospital - midwife, consultant, ward staff, volunteer

Social media

Antenatal classes

Post natal support classes (e.g baby massage classes)

Another pregnant woman/ pregnant person

Another new parent

Infant feeding support services

Other (please specify)

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* 18. If you are interested in chatting more to an MVP representative or would like to join our discussions please provide your details and we will get in touch.

Name

Email Address

Phone Number