Spinal Cord Injury, Urogenital Health
and Pregnancy

Section 1 - Demographic & Medical History Questions

DISCLAIMER: Thank you for your interest in participating in this survey. Please see below for a short description of our research purpose and your involvement in it.

This survey is intended for women over the age of 18 with a spinal cord injury (SCI). You may choose to fill out this survey yourself or with the assistance of someone else, however the answers must be your own.
The following survey was developed by Dr. Anne Berndl at the Accessible Care Pregnancy Clinic, at Sunnybrook Health Sciences Centre, in Toronto, Canada.

Dr. Berndl is a Maternal-Fetal Medicine specialist who focuses on pregnancy and physical disability. She has created this survey to address the lack of knowledge about reproductive health and pregnancy in women with SCI, which may affect the care they receive or the healthcare choices they make.
This survey was created with input from women with spinal cord injuries, and is funded by the Ontario Neurotrauma Foundation.
This survey is for research purposes, and may contain questions that seem invasive or may deal with sensitive issues. For example there are questions about sexual and reproductive health, as well as bowel and bladder health. You may skip any questions that you do not feel comfortable answering.  It should take approximately 30 minutes to complete.

This survey is completely anonymous. You will not be asked for your name or any other personal contact information unless you choose to provide it at the end of the survey in order to be contacted for a personal interview or participate in follow up studies.
Thank you in advance for your interest in participating in our research. It is hoped that this will improve healthcare for people with spinal cord injuries in the future.

If you have any questions about this study and your involvement, please do not hesitate to contact the Primary Investigator, Dr. Anne Berndl, at anne.berndl@sunnybrook.ca, or Research Coordinator Parvez Khatib, at parvez.khatib@sunnybrook.ca

The Sunnybrook Research Ethics Board has reviewed this study. If you have questions about your rights as a research participant or any ethical issues related to this study that you wish to discuss with someone not directly involved with the study, you may call the Chair of the Sunnybrook Research Ethics Board at (416) 480-6100 ext. 88144.

*1. I have participated in this study before.

v7.1.1 Parvez Khatib