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Kimberly
Prenatal Classes
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Class Evaluation for Parents
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Indicates required field
My class was taught by:
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I am a:
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Mother
Father
Partner
Friend
Relative
Doula
Dates of my classes:
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On a scale of 1 to 7, where: 1 = Terrible and 7 = Excellent
1. My Mentor:
was engaging and approachable:
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7 = Excellent
6
5 = Good
4
3 = So-s0
2
1 = Terrible
facilitated lively discussions with parents
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7 = Excellent
6
5 = Good
4
3 = So-so
2
1 = Terrible
asked thought-provoking questions that made the process of making birth are meaningful
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7 = Excellent
6
5 = Good
4
3 = So-so
2
1 = Terrible
inspired self-confidence
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7 = Excellent
6
5 = Good
4
3 = So-s0
2
1 = Terrible
gave clear answers and explanations
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7 = Excellent
6
5 = Good
4
3 = So-so
2
1 = Terrible
2. My comprehension of each of these pain-coping practices, based on my Mentor's instruction:
***If your Mentor did not teach the pain-coping practice, rate a "0" 7 = Excellent, 1 = Terrible
Breath Awareness
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7
6
5
4
3
2
1
0
Circular Breathing
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7
6
5
4
3
2
1
0
Non-Focused Awareness
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7
6
5
4
3
2
1
0
Drugs & Epidurals
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7
6
5
4
3
2
1
0
Finding the Center
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7
6
5
4
3
2
1
0
Footbath and massage
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7
6
5
4
3
2
1
0
Vocalizing/Co-chatting
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7
6
5
4
3
2
1
0
3. I rate my Mentor's capacity to build a pain-coping mindset by completing these statements, giving a number from 1 to 7,
where 1 = no confidence 3-4 = somewhat confident 7 = very confident
(If you are a birth companion, rate your confidence in
your
ability to cope ad help the birthing person in labor)
When I started the class, my confidence in coping with pain was:
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7 = very confident
6
5
4
3
2
1 = no confidence
Today, at the end of my classes, I rate my confidence in coping with pain as:
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7 = very confident
6
5
4
3
2
1 = no confidence
4. I rate how much I learned and appreciated the following, on scale of 1 to 7, where:
0 = not done 1 = totally useless 3 = somewhat helpful 5 = valuable 7 = extremely valuable
a) How Labor Works
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7
6
5
4
3
2
1
0
e) Cesarean
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7
6
5
4
3
2
1
0
b) Labyrinth of Birth
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7
6
5
4
3
2
1
0
f) Postpartum Adjustment
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7
6
5
4
3
2
1
0
c) Special Partner's Class
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7
6
5
4
3
2
1
0
g) Birth Art
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7
6
5
4
3
2
1
0
d) How to Ask Questions & Get Info
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7
6
5
4
3
2
1
0
5. What I liked and/or valued most in the classes and why:
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7. How these classes influenced my partner’s attitude towards labor, birth, and parenting:
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9. Anything else I want to share about the class, my Mentor, and/or my learning process:
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6. What I had the most trouble relating to during these classes was:
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8. How these classes influenced our relationship:
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Please type your name or initials below if you are open to having your comments used as a testimonial. Thank You!
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Kimberly
Prenatal Classes
Gift Certificates
Local Resources