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Questionnaire template

Maternity Care Feedback

Collects mothers' ratings of maternity care from first contact through antenatal classes, birth and postnatal care.

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Other · Motherhood. All Other templates

Questions in this template

Finding Our Service

  1. Thank you for choosing us for your maternity care. Your feedback helps us improve the service for you and other families.

  2. How did you first find out about our maternity service?

    Choose one:

    • Friends or family
    • Searching online
    • A health professional
    • Social media
    • Other

  3. Where did you hear about us?

    Condition: Shown when Other is selected

    Open answer

Quality of Care

  1. How satisfied were you with each of the following?

    • How attentive and professional the staff were
    • Availability of appointments and services
    • Information and communication you received
    • Cleanliness and comfort of the facilities
    • Overall quality of care

    For each row: choose one:

    • Very dissatisfied
    • Dissatisfied
    • Neutral
    • Satisfied
    • Very satisfied

Antenatal Classes

  1. Which of our antenatal classes did you go to?

    Choose any that apply:

    • Caring for a newborn
    • Breastfeeding
    • Preparing for birth
    • None

  2. How satisfied were you with each class?

    Condition: Shown when at least one class was attended

    • Caring for a newborn
    • Breastfeeding
    • Preparing for birth

    For each row: choose one:

    • Very dissatisfied
    • Dissatisfied
    • Neutral
    • Satisfied
    • Very satisfied
    • Did not attend

Labour and Birth

  1. Thinking about your labour and birth, are these statements true for you?

    • I felt as comfortable as possible.
    • The care team was supportive and professional.
    • My wishes for the birth were respected.
    • My pain relief was adequate.

    For each row: choose one:

    • Yes
    • Not sure
    • No

After the Birth

  1. How satisfied were you with the care you received after the birth?

    A number from 1 to 10

  2. Please tell us about your experience of care after the birth.

    Open answer

Recommendation

  1. Would you recommend our maternity service to others?

    Choose one:

    • Definitely would
    • Probably would
    • Might or might not
    • Probably would not
    • Definitely would not