Antenatal Consultation Questionnaire

The following questionnaire is designed to gain a greater understanding of the service provided by Antenatal Consultants and the impact on parents of preterm infants.

Please download the following questionnaire 'Antenatal Consultation - questionnaire' here (at the bottom of the page). Once complete please save it and email it back to This e-mail address is being protected from spambots. You need JavaScript enabled to view it


The follow questionnaire is not a functional online questionnaire and only serves as an example of the downloadable questionnaire (available at the bottom of the page- here

antenatal questionnaire for parents of preterm infants

 

Carer Details

Hospital - Enter Hospitial Here

Country - Enter County Here

Consultation provided by

Neonatologist

Neonatal fellow

Neonatal nurse practitioner

Pediatrician

Other _________________

Length of consultation

 

The Neonatal Specialist:

  1. 1.Gave me information about medical problems that my baby might have

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree


  1. 2.Gave me information about treatments my baby might need

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 3.Gave me information about the chances of survival for my baby 

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 4.Gave me information about the risk of mental or physical disability for my baby

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 5.Gave me information about breastfeeding my premature baby

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 6.Explained the difference between level II and level III care

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 7.Gave me information about how long my baby could be in hospital

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 8.Gave me information about when we could visit my baby in the neonatal intensive care unit

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 9.Gave me information about who could visit my baby in the neonatal intensive care unit

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 10.Gave me a chance to ask questions

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 11.Answered my questions in words that were easy to understand

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 12.Asked if I understood the information discussed

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 13.Took time to explain information that I did not understand

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 14.Asked if I had questions about information that had not been discussed

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 15.Gave me a chance to talk about my pregnancy

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 16.Gave me a chance to talk about how I was feeling

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 17.Gave me a chance to talk about what I was worried about

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 18.Gave me a chance to talk about my knowledge of premature babies

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 19.Gave me a chance to talk about my baby

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 20.Explained his/her role in the care of my baby

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 21.Explained that the neonatal intensive care unit team would begin care in the delivery room

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 22.Told me that my baby would be admitted to the neonatal intensive care unit

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 23.Explained that the neonatal intensive care unit team would be available at all times for attendance at the delivery

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 24.Explained that I was not responsible for my premature labour

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 25.Made it easy for me to talk about what I was worried about

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 26.Told me another meeting could be arranged for further questions

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 27.Offered me a tour of the neonatal intensive care unit to help me understand my baby’s care

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

  1. 28.I found it easy to talk to the neonatal specialist 

Strongly disagree        Disagree        Neither agree nor disagree        Agree        Strongly agree

 

Additional Questions

  1. 29.Is there any other information you felt you should have received but didn’t?
  1. 30.What could have been done to improve your overall satisfaction with the consultation?

End Questionnaire.

Please download the following questionnaire 'Antenatal Consultation - questionnaire' here (at the bottom of the page). Once complete please save it and email it back to This e-mail address is being protected from spambots. You need JavaScript enabled to view it


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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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