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études ? (non scolarisée, primaire, niveau 6 e à 3 e de l'enseignement général, niveau 5 e à 3 e de l'enseignement technique ou professionnel ou CAP, niveau 2 e à terminale de l'enseignement général, niveau 2 e à terminale de l'enseignement technique ou professionnel ,
est-il : étudiant, au chômage, en stage d'insertion, autre situation ,
avez-vous une couverture sociale ,
quel était ce traitement ? (un traitement par inducteurs de l'ovulation seuls, une insémination artificielle, une fécondation in vitro ,
visite(s) à domicile par une sage-femme ? (non, sage-femme de PMI, par une sage-femme libérale, par une autre sage- femme) ,
avant la prise de sang, vous a-t-on donné des explications sur ce type de dépistage ,
pour quel motif (âge maternel, après dosage sanguin, après signe d'appel échographique, autre motif en clair ,
quelle a été la durée totale de vos hospitalisations ? (en jours) ,
pourquoi ? (préparation non souhaitée, préparation non proposée, horaires inadaptés, distance trop grande ,
combien de séances avez-vous suivies ? Où avaient lieu ces séances ? (dans cette maternité, dans une autre maternité, dans un cabinet libéral ,
comment nourrissez-vous votre enfant ? ,
Antécédents obstétricaux (nombre de grossesse(s) antérieure(s), nombre d'accouchement(s) antérieur(s), nombre de prématuré(s) (<37 SA), nombre d'hypotrophe(s), nombre de mort-né(s), nombre d'enfant(s) né(s) vivant(s) puis décédé(s)) ,