Discrimination By Personal Characteristics

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): another reason, please specify:

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): for reasons I do not understand

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my partner’s or support person’s occupation

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my occupation (lawyer, etc…)

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my choice of birth place.

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my incarceration or history of incarceration.

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my substance use or history of substance use.

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my economic circumstances.

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my level of education.

During my pregnancy or birth care, I felt that I was treated poorly (please check all that apply): because of my marital status.