PPDKenya — Participant Interest Form

Hi! I'm Samoina, a PPD survivor, mom and founder of PPDKenya. I'm researching the experiences of Kenyan moms during pregnancy, after loss, and in the first year after birth — so we can rebuild better support for moms like you. This takes 2 minutes.

Q1. Which of the following best describes where you are right now? (Select one)

A

I am currently pregnant

B

I have experienced a pregnancy or baby loss

C

I am currently pregnant AND have experienced pregnancy or baby loss

D

I gave birth in the last 12 months

E

I am currently pregnant and gave birth in the last 12 months

F

None of the above

Q2. Are you comfortable having a relaxed conversation about your emotional experience during this period? (Select one)

A

Yes, I'm open to it

B

I'm not sure yet

C

No, not at this time

Q3. We'd love to have a relaxed 30–45 minute conversation with you.

A few things to know before you book:

👶 Your baby is welcome on the call — no need to arrange childcare 📞 You can choose how we connect — phone call, WhatsApp call, or Google Meet 🗓️ I'm available weekdays between 2pm – 5pm (EAT) 🎙️ With your permission, I may record the call for accuracy — only I will have access to it 🔒 Your name and contact details will never be shared publicly or with third parties ✋ You can stop the conversation at any time, no questions asked

If you're happy to chat, please fill in the below:

Your name:

Your preferred contact number or email:

How would you prefer we connect? (Select one)

A

Phone call (I will call you)

B

WhatsApp call

C

Google Meet

Suggest a date and time that works for you: (Weekdays, 2pm–5pm EAT)

Thank you so much for your time and trust. I'll be in touch within 2 business days to confirm our conversation. You're helping build something that could change lives for Kenyan moms. 💛