Post Class Evaluation-Birthing Person

Post Class Evaluation – Birthing Person

After you’ve finished your full childbirth class series, please complete this evaluation! This version is for the client who is currently pregnant. There will be a separate survey for your partner. A copy of this completed assessment will be sent by email to your own email address (to save for your own records), to your EBB Instructor (so that they can review your evaluation of their class), and to the EBB administrative team (for program evaluation).

Name(Required)
Name of your Support Person
Name of your EBB Instructor(Required)
CO-INSTRUCTOR: Name of your EBB Instructor
If your class has 2 instructors, list the second instructor’s name here. If you have only 1 instructor, leave it blank.
If your class has 2 instructors, list the second instructor’s email here. If you have only 1 instructor, leave it blank.

Your Birth Provider and Setting

Have you changed your birth provider since you started this class?
Have you changed your planned birth setting since you started this class? (i.e. switched hospitals)

Your Thoughts, Feelings and Knowledge

On a scale of 1 to 10, how do you feel right now about the approaching birth?
On a scale of 1 to 10, how do you feel right now about the approaching birth?
Which statement best describes the purpose of birth plans?
A pregnant person has arrived at the hospital in labor and is six centimeters dilated. The nurse says, "You're not allowed to eat or drink anything." Which statement below is true?
What are the parts of evidence based care? (Select all that apply)

You and Your Childbirth Class

Did you take any OTHER childbirth classes during this pregnancy?
Did you take a childbirth classes in a prior pregnancy?

Comfort Measures

Having FINISHED the class, how confident are you now in your ability to use the following comfort measures during labor?
Have you hired a doula?
How do you think your partner/support person will advocate for you during the birth? "My partner/support person would…" (Select all that apply)
Typing my name below will serve as my signature. I understand that my results will be sent by email to the Evidence Based Birth® administration team, my personal EBB Instructor, and my own email address.(Required)