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Yes
No
Yes
No
Yes
No
Accidental loss of urine
Feeling unable to completely empty my bladder
Having to void within a few minutes of a previous void
Pain or burning with urination
Difficulty starting or frequent stopping/starting of urine stream
None of these apply to me
Yes
No
Yes
No
Yes
No
Loss of bowel control
Feeling unable to completely empty my bowels
Straining or pain with a bowel movement
Difficulty initiating a bowel movement
None of these apply to me
Yes
No
Yes
No
Yes
No
True
False
Yes, less than 6 weeks postpartum
Yes, 7-12 weeks postpartum
Yes, 3-6 months postpartum
Yes 6-12 months postpartum
No, I am not less than 1 year postpartum