Thanks for your time in filling this survey; this will help us understand how to make the journey of pregnancy, child birth and post birth easier for moms.

We are two young female entrepreneurs working to develop products to make pregnancy and motherhood easier. We want to stay close to moms and moms-to-be and understand where we can help. It would be amazing if you can answer the following questions :)

Your participation in this study is voluntary. You are free to withdraw from the study without any penalty to you. Your data will be kept completely confidential and no personally identifiable information will be collected.   
There are no risks involved in this study other than what you would encounter in daily life. Potential benefits to you include receiving information about the outcomes of the study as well as references to related research if you are interested.     
Your data will remain completely anonymous and will not be released in any way that can be linked to you. Data from this study will be kept locked or password-protected, and will be destroyed when no longer needed for research purposes. Contact information: Daniela Mesalles (
Your name *
Your email *
Your age *
Country of Residence *
Country of Origin (Nationality) *
How many adults do you live with? (18+) *
How many kids do you live with? (under 18) *
Are you? *
How many children do you have? *
Who cooks most often in your household? *
How many times did you eat out or order food in the last month? *
What is your dietary routine? (please check as many as apply) *
How important is healthy eating for you? (10 - very important) *
Not very important
Very important
How many hours have you usually worked per week? (before you got pregnant or had a baby) *
Never submit passwords through Google Forms.
This form was created inside of Mamai Group. Report Abuse