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Single Motherhood Equity:
Advocacy Survey

To better advocate for single moms and single pregnant women, we invite you to complete the "Single Motherhood Equity" Advocacy Survey. Your responses will help us identify key challenges, understand needs, and develop meaningful solutions. All information collected is strictly confidential and will be used solely to guide our advocacy efforts.

You are welcome to answer as much or as little as you feel comfortable. Every response makes a difference, and we deeply appreciate your willingness to share your experiences.

Single Motherhood Equity: Advocacy Survey

Demographic Information

Race/Ethnicity

Type what State if in US. Type what Country if outside of the US.

Age
Education Level

What is the highest level of education you’ve completed?

Which of the following best describes your living area?

Socioeconomic Information

Annual Household Income
Housing Status
Employment Status

Family and Parenting Dynamics

How many children do you have?
Are you currently pregnant?
Yes
No
Co-Parenting Status
Actively co-parenting
Minimal or no co-parent involvement
Have you experienced intimate partner violence or abuse?
Yes, currently
Yes, in the past
No
Prefer not to answer

This question is optional. Your response will remain confidential and is used only to better understand the challenges faced by single moms and moms-to-be.


If you or someone you know needs help, please contact the National Domestic Violence Hotline at 1-800-799-7233 or text 'START' to 88788

Health and Well-being

Access to Healthcare

Do you currently have health insurance?
Yes
No
Do you have access to prenatal/postnatal care?
Yes
No

Mental Health Resources

Have you accessed any mental health support in the past year?
Yes
No

Financial and Social Support

Government Assistance

Are you receiving any of the following? (Check all that apply)

Community Support

Do you have access to supportive programs or groups in your community?
Yes
No

Challenges and Support Needs (optional)

Thank You

Solo Stork

To connect or for support
through your journey, email us at

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