Post-Partum Screen Child's Name(Required) First Last Mom's Name(Required) First Last 1. I’ve been able to see the funny side of things...(Required) As much as I always could [1] Not quite as much now [2] Definitely not as much now [3] Not at all 2. I have looked forward with enjoyment to things...(Required) As much as I ever did [1] Rather less than I used to [2] Definitely less than I used to [3] Hardly at all 3. I’ve blamed myself unnecessarily when things went wrong...(Required) No, never [1] Not very often [2] Yes, some of the time [3] Yes, most of the time 4. I’ve been anxious and worried for no good reason...(Required) No, not at all [1] Hardly ever [2] Yes, sometimes [3] Yes, very often 5. I’ve felt scared or panicky for no good reason:(Required) No, not at all [1] No, not much [2] Yes, sometimes [3] Yes, quite a lot 6. Things have been getting on top of me…(Required) No, I’ve been coping as well as ever [1] No, most of the time I cope quite well [2] Yes, sometimes I haven’t coped as well as usual [3] Yes, most of the time I haven’t been able to cope 7. I’ve been so unhappy that I have difficulty sleeping...(Required) No, not at all [1] Not very often [2] Yes, sometimes [3] Yes, most of the time 8. I’ve felt sad or miserable...(Required) No, not at all [1] Not very often [2] Yes, quite often [3] Yes, most of the time 9. I’ve been so unhappy that I have been crying...(Required) No, never [1] Only occasionally [2] Yes, quite often [3] Yes, most of the time 10. The thought of harming myself has occurred to me...(Required) Never [1] Hardly ever [2] Sometimes [3] Yes, quite often CAPTCHA
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