Did you have any illnesses or problems during the pregnancy?YesNo

Please select if you have had any of the following tests or scans (Hold ctrl/cmd to select multiple answers)Early Viability Scan (dating/viability) - NHSEarly Viability Scan (dating/viability) - PrivateCombined Test (Nuchal Scan and Blood Test) - NHSCombined Test (Nuchal Scan and Blood Test) - PrivateQuad Test (bloods 15-18wks if not had Combined Screening) - NHSQuad Test (bloods 15-18wks if not had Combined Screening) - PrivateNIPT (NiftyHarmonyPanorama) - NHSNIPT (NiftyHarmonyPanorama) - PrivateAnomaly Scan - NHSAnomaly Scan - PrivateCardiac Scan - NHSCardiac Scan - PrivateWellbeing Scans after 24 weeks - NHSWellbeing Scans after 24 weeks - Private4D Baby Bonding Scan - NHS4D Baby Bonding Scan - PrivateAmniocentesis - NHSAmniocentesis - PrivateCVS - NHSCVS - PrivateGroup B Strep Screening (rectovaginal swabs) - NHSGroup B Strep Screening (rectovaginal swabs) - PrivateCervical Scan - NHSCervical Scan - PrivateFetal Fibronectin (pre-term labour screening) - NHSFetal Fibronectin (pre-term labour screening) - Private

What was the outcome of the pregnancy?LivebirthStillbirthMiscarriageMedication TerminationSurgical Termination

How did you deliver?Vaginal (spontaneous)Vaginal (induced)Caesarean (elective)Caesarean (emergency)

How many babies did you have?1234

Baby SexMaleFemale

Was the baby admitted to SCBU?YesNo

Does the baby have any problems?YesNo

Baby SexMaleFemale

Was the baby admitted to SCBU?YesNo

Does the baby have any problems?YesNo

Would you be happy for us to share your anonymised clinic experience on our website etc?YesNo

0 + 4 = ? Please prove that you are human by solving the equation *