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During the INFACT Campaign we have concentrated solely on Sodium Valproate as we were aware that it was the anti epilepsy drug which caused more problems during pregnancy than any other drug.

The next part of our campaign we will be also concentrating on other medications and the problems they also create for the fetus/baby during pregnancy, as we believe every woman deserves an informed choice when it comes to making decisions for her health, her child's and his/her future.

This survey is of great importance to our work and that with the Medicines and Healthcare Products Regulatory Agency (MHRA) especially as they and the Commission for Human Medicines have begun there own research on the other medications.  As we embark on the discussions surrounding other medications your responses are important if you are prescribed other anti epilepsy meds in your child bearing years too.

INFACT would like to thank you for your time, and we look forward to receiving your answers.

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* 1. How many children have you had while prescribed/taking any anti epilepsy medication?

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* 2. How old are your children

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* 3. Which medication are you taking at present

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* 4. What condition is your medication prescribed for.

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* 5. Which medication did you take during your pregnancies (please answer by adding the number of your pregnancy next to the drug, eg: child 1 &3, if you have had more than one child.

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* 6. What was the dose of your drug during pregnancy. (please add your total amount of each for the day, eg 100 )

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* 7. Please tick the problems/disabilities your child suffers/diagnosed with

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* 8. This next question is a very delicate one.  Have you ever experienced a Miscarage, stillbrith or as termination due to problems in pregnancy

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* 9. Please tick which medication you were taking during a pregnancy loss whether it be miscarrage, stillbirth or termination due to problems in pregnancy.

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* 10. Has your GP or Specialist ever discussed with you the risks of taking your medication during pregnancy

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* 11. Have you ever been sent for pre-conception counselling?

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* 12. Were the risks of your medication in pregnancy ever discussed with you by your Midwife or ante-natal clinic

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* 13. Was your baby checked over by a Geneticist after birth

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* 14. Do you recieve a Patient Information Leaflet with your medication

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* 15. Do you ever read your Patient information Leaflet

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* 16. If you have read your patient information leaflet and the information of pregnancy and breastfeeding, have you brought this up with your Dr or pharmacist

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* 17. If you did bring the topic of pregnancy up with your Dr, did he/she offer you further advice or information

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* 18. If you wanted to become pregnant and found that you mediciation has the possibility of affecting your baby would you..

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* 19. Do you ever discuss your medication with your Pharmacist

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* 20. Does your pharmacist ever mention to you the dangers of taking your Anti-convulsant during pregnancy.

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* 21. Thank you for taking our survey, if you would like further information about anti-convulsant medications in pregnancy and a copy of our Information Pack please leave your full name and address, including your postcode below.

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