Pregnancy Loss Support Tool Startpress Enter Since your pregnancy ended do you experience or require any of the following? Heavy vaginal bleeding * Yes No Change and/or offensive (smelly) vaginal discharge and/or abdominal pain * Yes No Required further medical or hospital appointments and/or further investigations * Yes No Low tolerance to activity/easily tired * Yes No Low mood, mood swings, irritability, anger, crying spells, nervous tension/anxious, social withdrawal * Yes No Poor concentration, confusion, memory problems, clumsiness * Yes No Difficulty falling asleep and/or staying asleep * Yes No Feeling bad about yourself, guilt, and/or that you have let yourself or your family down * Yes No Thoughts that you would be better off dead or of hurting yourself in some way * Yes No I would like additional support from my employer regarding my pregnancy loss and what I feel comfortable sharing * Yes No Submit If you are human, leave this field blank. ContinueSubmit Use Shift+Tab to go back