We are very sorry for your loss, and we appreciate that this is an extremely difficult time for you. This questionnaire is for women and their partners that have experienced the loss of their baby/babies during pregnancy, or shortly after birth. Please complete as much or as little of the form that you are able to. Some questions may not be relevant to your experience.
Please select the relevant answer for each question, and type any comments you may have. All information given will remain anonymous unless you wish to provide your contact details at the end of this questionnaire. If you would like to discuss any aspect of your care, please contact the bereavement midwives.
