Birth Story Template

For those of you who would like some help organizing your thoughts into words, feel free to use this template as a survey for your birth stories. Copy and paste the information into a word document, and send the attachment via e-mail to my address. You will find the link under the "Contact Me" page of this blog. Thank you again for your time and help in gathering this most important information for my book!

Name (You may use a pseudonym)
Age
Single, Married, Divorced, Widowed
City and Sate of Residence
List All Children Born To You,  (A pseudonym may be used for names)
Their Year of Birth and Gender
Describe Each Pregnancy In Terms of: Prenatal Care, Birth, and Postpartum Recovery
Give Your Overall Feelings Associated With Your Experiences
(The more information you can give, the better. You may reference my personal birth stories as an example.)

Also include a way that I can contact you with questions I may have about your information.
An e-mail address would be recommended.

Remember, if you would like to do a live interview with me we can schedule an appointment via the internet, just send me an e-mail and we can get started right away!