Already Had A Baby

Your experience matters. This is your opportunity to speak up and help shape a better hospital birth system for future parents or for your own future births.

Print a letter to provide feedback to your hospital after your birth

If you have had a hospital birth in the last 5 years, and would like to provide feedback to your hospital, please fill out the following questionnaire. It should take less than 10 minutes of your time. Once you submit the form, you will be able to preview, edit and print the letter to be signed and mailed to the hospital. (Note: A copy of the letter will be emailed to us for statistical purposes. You will not be on a mailing list or receive spam).

First Name *

Last Name *

Address *

Address Line 1

City

State

Zip Code

Hospital *

Delivery Date *

Did you have a doula at your labor and birth?

Were you able to wear your own clothes instead of a hospital gown during labor and birth?

Did the nurses respect and follow your birth plan?

I was allowed to labor out of the hospital bed

I was allowed to eat during labor

My hospital provided (wireless) telemetry monitoring and I used it

The nurse used a doppler to listen to my baby instead of a monitor

I was able to labor in the tub...

I was allowed to give birth in a tub

Did your hospital have midwives available?

I was allowed to give birth in an alternative position other than on my back with my feet or legs in stirrups or leg supports by my _____

Did you have pain medication in labor?

Did you have a surgical birth (c-section)?

The hospital allowed photos to be taken during labor and birth

The nurses provided the help I needed with laid back or baby led breastfeeding

Did your doctor or midwife wait for the umbilical cord to stop pulsating before it was clamped and cut?

Did you get skin-to-skin contact immediately following the birth?

I was allowed full rooming in with my baby

My overall experience giving birth at this hospital was

Captcha *

What is the third letter of the alphabet?

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