How many vaginal births have you had?

How many cesarean births have you had?

How old are you?

Do you have symptoms of a weak pelvic floor?
Yes No Not sure
Have your symptoms existed since you last gave birth?
Yes No Not sure
If not, how long after your last pregnancy did your symptoms begin?
Less than 1 year 2 - 5 years 6 - 10 years More than 10 years
How long did you put up with your problem before deciding to do something about it?
I acted immediately Less than 6 months 6 months - 1 year 1-5 years 6-10 years More than 10 years Doing nothing. Will put up with it as it is.
Have you talked to any of the following about your problem?
Health professional Partner Family member or friend Other
What solutions have you tried so far?

Which solution worked best for you?

Please feel free to add any other information



Thank you again!