WOMEN'S SEXUALITIES

Generations of Women Share
Intimate Secrets of Sexual Self-Acceptance

Questionnaire
O. The Questions in This Section Are About Pregnancy.

If you have never been pregnant and never wanted to be pregnant, please circle 0 and skip to the next section, Section P.

0

1. Please indicate if you have ever been pregnant and fill in any other blanks that apply:

a. I have been pregnant________ times.

b. _______________of my pregnancies were planned.

c. _______________of my pregnancies were unplanned

d. _______________of my pregnancies resulted in live births.

e. _______________of my pregnancies ended in spontaneous abortion or miscarriage.

f. _______________of my pregnancies ended in an arranged abortion.

g. _______________of my babies were given up for adoption.

 

2. At some time in my life, trying to become pregnant enhanced my sexual pleasure and/or satisfaction.

 

Strongly Disagree					Strongly Agree		NA
1	2	3	4	5	6	7	0

 

 

 

3. At some time in my life, I had difficulty becoming pregnant when I wanted to.

Strongly Disagree						Strongly Agree	NA
1	2	3	4	5	6	7	0

 

 

 

4. At some time in my life, trying to become pregnant diminished my sexual pleasure and/or satisfaction.

 

Strongly Disagree					Strongly Agree		NA
1	2	3	4	5	6	7	0

 

 

 

5. At some time in my life, I have undergone medical testing and/or interventions for fertility.

____Yes

____No

 

 

If you have never been pregnant, please skip to Question 8.

6. In my life, becoming pregnant has resulted in the following (check all that apply):

___I married someone I had not previously planned to marry.

___I married someone I never would have chosen to marry otherwise.

___I married someone at the time who was not the biological father.

___I had a baby in marriage before I felt ready.

___The biological father knew about the pregnancy but did not remain with me through it.

___The biological father never knew about the pregnancy.

Other _____________________________

None of the above_____________

7a. I am pregnant now._____Yes ______ No____Not sure

7b. I have a baby I currently breastfeed. ____Yes ______ No

7c. I have sometime had a baby delivered by Cesarean section. _____Yes ____ No

8. During, or as a result of, partner sex during the last 3 months I have felt (check all that apply):

Desirous of becoming pregnant._____Yes ______No

Concerned or fearful that I might not become pregnant.______Yes ________No

Concerned or fearful that I was pregnant._____Yes _____ No

Concerned or fearful that I might become pregnant._____Yes ______No

None of the above._______________

 

Remember

The questionnaire is here for VIEWING ONLY.
Please DO NOT send your answers to me.

Copyright 1998 Carol Ellison, Ph.D.