QUESTIONNAIRE CHECKLIST

Name: Address:

Part 1. Please answer the following items honesty and accurately,

A. Socio-demographic Factors
Age

Civil Status ( ) Single ( ) Separated

( ) Married ( ) Widowed

Highest Educational Attainment ( ) Postgraduate ( ) Highschool Grad

( ) Graduate ( ) HS Undergrad
( ) College Graduate ( ) Elementary Grad
( ) College Undergrad ( ) Elem Undergrad
( ) Vocational/Cert. ( ) No Schooling

Occupation

Family Monthly Income ( ) Above P20, 000

( ) P15, 001 – P20, 000
( ) P10, 001 – P15, 000
( ) P5, 001 – P 10, 000
( ) P5, 000 and below

Religion ( ) Roman Catholic ( ) Others, pls specify

 Kindly put a check mark ( ) on the column corresponding to your answer for each item
asked.
A. For Postpartum Belief, kindly be guided by the following scale:
5 – Strongly Agree (SA)
4 – Agree (A)
3 – Undecided (U)
2 – Disagree (D)
1 – Strongly Disagree (SD)
B. For Postpartum practices, please refer to the following scale:
5 – Always (A)
4 – Often (O)
3 – Sometimes (S)
2- Rarely (R)
1 – Never (N)

A. Postpartum Beliefs B. Postpartum

POSTPARTUM BELIEFS AND Practices
PRACTICES
5 4 3 2 1 1 2 3 4 5
SA A U D SD N R S O Al

I. Dietary Restrictions & Preferences

1. I eat/drink the following foods in
accordance to “tanggad”:
a. Green leafy vegetable (e.g. camote
tops, ampalaya leaves)
b. Other vegetable such as
stringbeans, “kabatiti”,
“sabunganay”, papaya
c. Seashells
d. Roasted lean meat, fish
e. Sweet and succulent fruits
f. Beverage
2. I do not eat/drink the following foods
because they have ill effects on health:
a. Anything cold (e.g ice cream,
refrigerated or frozen food/drinks)
b. Anything caffeinated (e.g coffee,
softdrinks, tea)
c. Alcoholic beverage, drugs & other
harmful substances
d. “Bagoong” (fish paste, anchovies)
e. Fatty foods
f. Sour fruits, food and drinks
g. White squash
h. “Kilawin” (raw meat)
i. “Papait”
j. Octopus
 C. Postpartum Beliefs D. Postpartum
POSTPARTUM BELIEFS AND Practices
PRACTICES
5 4 3 2 1 1 2 3 4 5
SA A U D SD N R S O Al

II. Hygiene
1. I observe the following practices to
enhance health recovery:
a. Sponge baths with hot water
gradually cooling down
b. Herbal bath (e.g, guava leaves)
c. Sitz bath (“sidor”, “sangrab”-
warming vulva with hot steam or
sitting on burning coals wrapped
in cloth)
d. Rubbing alcohol on skin after
bathing
e. Gargling with glass of lukewarm
water with salt
2. I do not include the following
activities in observance of “tanggad”:
a. Scrubbing the skin
b. Brushing of teeth (for one week)
c. Combing hair
III. Behavioral Restrictions & Preferences
1. After delivery, I limit my physical
activities to the following:
a. Bed rest
b. Keeping my body warm (e.g,
wearing long sleeved shirt,
pajamas, socks, bonnet; using
blankets applying warm
compresses)
c. Keeping the room where I stay
warm (closing the windows, not
using electric fans/air condition)
d. Wearing binder around chest,
waist, hips for a month
e. Staying indoors for a month after
delivery or not walking about to
avoid exposure to wind, drizzle,
rain
f. Receiving body massage
2. I do not perform the following tasks
when observing “tanggad”:
a. Doing household chores,
especially those that require use of
 cold water (e.g, laundry, cooking,
watering plants, etc.)
b. Activities that strain the eyes (e.g,
watching television, reading,
sewing, etc.)
c. Walking up and down the stairs,
carrying heavy objects
d. Engaging in sexual activity for
three months after delivery
IV. Infant feeding
1. I practice breastfeeding to keep my
baby well-nourished
2. I let the baby suck on the first milk
(colostrum)
3. If the baby accidentally bumps my
breast, the resulting pain can be
relieved if I guide his hands or feet in
massaging the area hit
4. When the baby has been off the breast
for a few days or week, the milk in the
breast sours so I squeeze & discard the
initial ejected milk before resuming
breastfeeding
5. I clean my breast with lukewarm
water before & after breastfeeding
6. I breastfeed to help the uterus return to
its original size & prevent postpartum
bleeding