PHINMA University of Iloilo

College of Allied Health Sciences

Rizal Street, Iloilo City
Questionnaire
Name (Optional):___________________________________
Date:_______________________
Ngalan (indi ubligado)

Petsa

Part I. Demographic Profile

(Una nga Parte: Demographic Profile)
Direction: Please answer the data that is being asked honestly. Write your answer on
the space provided for each information or check the box of the desired answer.
(Pagpanudlo: Palihog sabat sang tampad ang mga palamangkuton. Ibutang ang imo
sabat sa lang-at pagkatapos sang kada pamankot ukon nutangan sang marka ang
kahon sang imo sabat.)
Age: ___________________________
(Edad)
Monthly Income:
(Bulanan nga Sweldo)
0 4,500 pesos a month (0 4,500 pesos taga bulan)
4,500 10,000 pesos a month (4,500 10,000 pesos taga bulan)
More than 10,000 pesos a month (masobra 10,000 pesos taga bulan)
Educational Attainment
()
Elementary graduate (Naka gradwar sa elementarya)
High-school graduate (Naka gradwar sa high-school)
College level (Naka eskwela sa colehiyo pero wala ka gradwar)
College graduate (Naka gradwar sa colehiyo)
Part II. Level of Awareness on Risks of Home Delivery
(Ikaduwa nga Parte: Lebel sang Pagkabalo Gikan sa Risgo sang Pagbata sa Balay)
Statements
(Mga pagpangasoy)
Maternal Risks
1. Mothers who give birth at home are
at a higher risk for suffering post-

Know

Not sure

Dont
know

2.
3.
4.
5.

partum hemorrhage.
Maternal deaths are higher in home
deliveries.
Prior C-section is a contraindication
for a home delivery due to possible
uterine rupture.
Placenta may not be fully delivered at
home deliveries.
Complications of home deliveries are
not limited to newborns but also
include mothers.

6.
Neonatal Risks
1. Births at home are ten (10) times
more likely to be stillborn.
2. Babies born at home are two to three
times more likely to die shortly after
birth.
3. There is a high risk for neonatal
seizures in home deliveries.
4. Babies born at home are more likely
to have neurological defects.
5. Neonatal deaths are higher in home
deliveries.
6. Babies delivered at home are mostly
born preterm and with low birth
weights
7.
Legality of home deliveries in Estancia, Iloilo
1. Home deliveries are prohibited in
Estancia, Iloilo.
2. Penalties are given to those who give
birth at home in Estancia, Iloilo
according to Ordinance 2011-001.
3. There are penalties for those who
assist in home deliveries in Estancia,
Iloilo according to Ordinance 2011001.
4.