FunkyMunkey

Hi, Im doing a survey for my final school project . All answers will remain anonymous

Thanks

1) How old were you when your first child was born?

<14 ____ 15-17 ____ 18-19 _____

2) Was the pregnancy planned?

Yes ______ No______

3 a) Were you on birth control when the baby was conceived?

Yes _____ No _____

b) If answered yes, what form(s)?

4) What was your families’ reaction to your pregnancy?

5) Did you ever consider having an abortion?

Yes _____ No _____

6) During your pregnancy did you live with your parents?

Yes_____ No______

b) If answered no, where did you live?

7) Did you experience any health issues during your pregnancy (Anemia, etc.)? Describe if applicable.

Yes_______ No________

8a) Was the baby born premature?

Yes _____ No _____

b) If answered yes, by how many weeks?

_______________________________________

9) How much did the baby weigh when he/she was born?

10a) Did the baby suffer from any health issues?

Yes____ No ______

10b) If answered yes, describe the health issues.

11) What is your highest level of education attained?

12) How do you financially support yourself?

Employment _________

Welfare_____________

Child Support __________

Rely on Parents ________

13) Did your pregnancy have an effect on your social life? Describe how it has or has not.

14) Is the child’s father still involved with raising the child? To what extent?

15) Do you wish you had waited longer before having children? Why or why not?

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