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How many weeks pregnant are you?

Less than 38 weeks
Between 38-40 weeks
Over 40 weeks

How many centimeters dilated are you?

0-1 centimeters
2-3 centimeters
3 or more centimeters
Unsure

What percent effaced are you?

Less than 50%
Between 50-80%
Between 80-100%
Unsure

Are you having Braxton-Hicks (practice) contractions or tightening in the lower abdomen?

No
Less than 4 per day
Between 4-12 per day
More than 12 per day or several an hour
Unsure

Are you scheduled for a non-medical induction?

Yes
No

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