Motherhood Questionnaire

Answers marked with a * are required.

1. General Questions

These questions are for a book. Any responses given may be used in part or in full for use in the book. Your responses may be edited for grammar or length.

Sections of this include pregnancy, adoption, foster parenting, depression & faith. Thanks!

Please answer all questions on this main page, as it will help us break down our demographics.

1. Please provide your first name only. *

2. What state do you live in (or region and country if not USA, ie: Queensland, Aus)? *

3. How old are you? *

4. What is your marital status? *

Married (first marriage)

Single

Divorced

Re-Married (2nd time or more)

Widowed

5. How old are your children right now? *

6. Prior to having children, what had you thought your plans for family would be?

7. In one paragraph, please tell us your motherhood story. IE: I got married at 22 and we started trying to get pregnant a year later. It took 8 months, but we became pregnant and I had a little boy. About 18 months later, I became pregnant again and our daughter was born a little premature, but perfectly healthy. We're now trying to get pregnant with baby #3.

8. Were you adopted or a foster child yourself? If so, please share any part of your story you would like. We appreciate your viewpoint on these topics.


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