Skip to main content

Table 2 Psychosocial questions as contained in ObstetriX™

From: Obstetric and psychosocial risk factors for Australian-born and non-Australian born women and associated pregnancy and birth outcomes: a population based cohort study

History of mental health treatment

Text field

Pattern of alcohol consumption

Text field

Illegal drug usage

Text field

Drug support needed

Text field

Currently on drug support

Text field

“Is there someone to talk to about your feelings or worries?”

Yes / no / not sure / unable to ask

“Will you be able to get practical support after the birth of your baby?”

Yes / no / not sure / unable to ask

“In the last 12 months have you had any major worries, stress or change?”

no / financial difficulties / housing changes / relationship worries / significant isolation / loss or death / other / unable to ask

“Generally do you consider yourself a confident person?”

No / yes / sometimes / unable to ask

“Does it worry you a lot if things get messy or out of place?”

No / yes / sometimes / unable to ask

“Have you ever felt anxious or depressed for more than 2 weeks?”

No / yes / unable to ask

If yes, “did any episode seriously interfere with your work or relationships?”

No / yes

And “were any of these episodes of anxiety related to pregnancy or birth?”

No / yes PND / yes – postnatal psychosis / other / not known

Child living away

Text field

Department of Community Services

Text field

Frightened by partner

Text field

Would you like assistance with this

Text field

Response to DV questions

Text field

Other issues or worries

Text field

EDS total score

Text field

Answer to EDS question 10

Text field

Psychosocial assessment – issues identified?

Text field