1 - ESDS
1 - ESDS 1 - ESDS
DWQ38 TO 7HOSE WHO HAVE NOT HAO A S7ERMJSATSONOPERATION TO PREVENT PREGNANCY If you am pregnnti now,nng [0] If you am not pmgnmntnuwor armunsure,nng [10] bMIichof me followngmeutod(a)of preventingpregnam, If any, worn YOU(oryour @nnr) usingwhm you bRaMO prognantT DW03SANY Ifnorrmthod uskdatall. ting ----- . . . . . . . . 0WQ3S If usually using .mw .x mom mathod% ring ●ll the nunbom that ●pply Wlthdravml ShaW!4am00m S8ti pmdmyihm method Ca@dla@wmgm CorSmmPtr4sspnngm PM mm PL!I(progestnmnontf) PM mmbmd pll (Indkllng muffl-pftamcPIII) Pill notsum i miniorcomblrnd Plea- wnt8 the bmti nmm imtow . __________ lUD/coMtira+mnnc dewca Foama/gatWqxa~pcMnes (sPanmrtes) Inpatons Ancthw method PIUU wnta tts narfm bd.aw ____ --.._ .—.— owta40 Plmu puta nngaroundth~ numbar,oppo~a ma smmmardwhti appltedio you at tha Urn*you bacama pregnant 0WG41 MET VVWSTmalhod dldyou US8most.anmn? [0] [01 [0] [0] [0] [0; [0] [0] lo] l! [0] W* onV um~ onmmdtod [0] M ussd mom mm ona methodm ●time [0] Samattmasw uatd ona method.aorrmtlnwsutothar [01 Pleaaml-k at th Ilst at 0WG3S for ttm n~ti of HI* mathod ●id vmm that nudr m ma box --—---- _ 0W04ZNG How bnq had mu nnmnd (cumbmahonof mmthods)hen tha one You us.mltyused, mat mfhe ormYouu-d nIoStaRmr? Ring the !tUMLWrWh!ChaPplias tO you Les9 man 3 months [0] At kast 3 months lau than6 months [0] At but 6 months,Iasathan 1 year [01 At least 1 yaw, leg than 2 yearn [0] At lead 2 YCW3 [0] [0] Cmcl — Go ta 0W39ANY/ DW039 — G.3la 0W47 m —’atoowxo — (2a ta 0W43LNG — Go ta 0W041 MET — Go to t3VAXZLNG — Go 100WM3 _ ReturnformM Inmwmvmr 9 296
0WQ43 Which of the tilbtig mdwd(s) of prewntlng pmgnmcy, if any, did you (or yourpalner) usmw u- Itm’mdhkly bdom that? If you had no SOXIUImladonship, ring . . . . . . . . If no ImathOdUwd ●t all, ring .. . . . . . . . . . . . If you WGMpmglunt ring .. . . ..-—— ------ If usually tming ona or mom methods, ring ●ll the ntmnbem that apply Wlthdmwal.......................................................................... Shnthlccmdom .................................................................. Sati poriori%hyth method................................................ Ca#dbphmgm . ............ ......................... ....... ................. cOntmG@W SpOngc... ......... ......... . ....... .................... Pit minipill(pmgoatamnoniy) .......... . . ....... ..... . .... Pm cambinadpill(irmiudingmuiii.pha@cpill) ................... Pllkrnt aura if minior combined .......... .............. . .... PI-- Wti NM brand nams blow ..-----—. luo/c9Wntm.mwlM *via ......... ... . ............. ............... Foams/gal#sF4ws!mMtiea (awmioid-) . .................... 0oin9 withoutSOmmliri+ardoumsto avoidpmgtmrwy Ipns ............... ..................... . ........ ........................ Anothw method Pleasa write its nana Maw --- . . ..————.._... TO THOSE wHO OID NOT USE A MEINOO AT YHE TIME OF BECOMING PREGNANT Hem is a Ilstof masonawhy psopledo not uas any mernodforpreventing pregnancy. Wltkh maaon lw~d to you? 0WQ44SAS wanted to haw a baby ........................................ ............. [0] DWGUMEN unlikelyto concstie beau= of menOp.3ua9...................... [0] 0wY441NF unlikelyto Conwive becaurn posaibFfrnfeftw ...... . .......... [0] 0WQ44UNS Omit Iika cmdmc@lc.n atior Ilnd rrwthoda Unatlfactov .......... .. ..... ......... .................................... [0] 0WQ44REL Ag8ind tmchings of Chutimligoua belhf .. ...................... [0] Owauow AnetlwJImm Plaasa Wlih yOIUmason below ... . . . . . . . . [0] 0WQ4S Inthelast2Yom havayou (oryour pd~er) !$zedany of the matimds of preventingpregnancyIhted at 0WQ49 on me nexl page? [0] [0] [0] [0] [0] [0] [0] [0] [01 [0] [0] [0] [0] [0] [0] Yes ... ... .... . . .... .... ..... . . ..... . ... ....`... .. .... [0] No ..................................................................................... [0] 10 — Ratom formto lntwviwmr —G0t00vm4s — eatOowMO — Returnmm! M m+mvmwar
- Page 1 and 2: SWQ33 TO 7HOSE WHO HAvE NOT HAO A S
- Page 3 and 4: sWQ41 If you (or your partner) used
- Page 5 and 6: SWQ47 Please put a rtng around the
- Page 7 and 8: &d7
- Page 9 and 10: DWQI ~nldng of your (mast Mant) Man
- Page 11 and 12: DwQi 1 Hava yOUever had a blby? NO=
- Page 13 and 14: owa19 TO TWOSEwHO ARE NOT PREGNANT
- Page 15: DWQ33NHS Was tie oporatinncati out
- Page 19 and 20: DWQ50 WIIkh of the fallowingmdhod(s
- Page 21 and 22: TO THOSE WliO 00 NOT USE A MEl1100
- Page 23 and 24: Mwm Thinidngof yourpmsmt man?agg,dl
- Page 25 and 26: (A) (s) (c) 1 I Child Firstbom Seco
- Page 27 and 28: MWQ20N0 How many ctwdmndo youminkyo
- Page 29 and 30: W241WH MWQ34PWH Oldyoumldhe hava th
- Page 31 and 32: Mwau Wflcll of thd followingmethod(
- Page 33: MWQ61 WIIich of ttw foibwingmethod(
- Page 36 and 37: “PP]UOuf-641(b) SG CONTINUOUS HOU
- Page 38 and 39: CONTINUOUS HOUSEHOLD SURVEY i Dotmm
- Page 40 and 41: EOUSEEOLD TYPE A CODE (02-3) Valuas
- Page 42 and 43: Y aa3 m 4 \N 4 \ z uco6 ,
- Page 44 and 45: _— Employment Status ~ EHp —. Q
- Page 46 and 47: — Quastlonnaare R= f Qumst~on No
- Page 48 and 49: Questionnaire Ref Coding Sheet No o
- Page 50 and 51: Questionnaire Ref Question No Q1 Q2
- Page 52 and 53: Questionnaire Ref 1 Coding Sheet No
- Page 55: Quaat,onnaxra Ref Codang Sheet No o
- Page 58 and 59: Questionnaire Ref Question NO Q1l(A
- Page 60 and 61: Questionnaire Ref Question No Q1l(A
- Page 62 and 63: Quest ionnaire Re f Question No Q1l
- Page 64 and 65: Questionnaire Ref Coding Sheet No o
DWQ38 TO 7HOSE WHO HAVE NOT HAO A S7ERMJSATSONOPERATION<br />
TO PREVENT PREGNANCY<br />
If you am pregnnti now,nng [0]<br />
If you am not pmgnmntnuwor armunsure,nng [10]<br />
bMIichof me followngmeutod(a)of preventingpregnam, If any, worn<br />
YOU(oryour @nnr) usingwhm you bRaMO prognantT<br />
DW03SANY Ifnorrmthod uskdatall. ting ----- . . . . . . . .<br />
0WQ3S If usually using .mw .x mom mathod% ring ●ll the nunbom<br />
that ●pply<br />
Wlthdravml<br />
ShaW!4am00m<br />
S8ti pmdmyihm method<br />
Ca@dla@wmgm<br />
CorSmmPtr4sspnngm<br />
PM mm PL!I(progestnmnontf)<br />
PM mmbmd pll (Indkllng muffl-pftamcPIII)<br />
Pill notsum i miniorcomblrnd<br />
Plea- wnt8 the bmti nmm imtow . __________<br />
lUD/coMtira+mnnc dewca<br />
Foama/gatWqxa~pcMnes (sPanmrtes)<br />
Inpatons<br />
Ancthw method<br />
PIUU wnta tts narfm bd.aw ____ --.._ .—.—<br />
owta40 Plmu puta nngaroundth~ numbar,oppo~a ma smmmardwhti<br />
appltedio you at tha Urn*you bacama pregnant<br />
0WG41 MET VVWSTmalhod dldyou US8most.anmn?<br />
[0]<br />
[01<br />
[0]<br />
[0]<br />
[0]<br />
[0;<br />
[0]<br />
[0]<br />
lo]<br />
l!<br />
[0]<br />
W* onV um~ onmmdtod [0]<br />
M ussd mom mm ona methodm ●time [0]<br />
Samattmasw uatd ona method.aorrmtlnwsutothar [01<br />
Pleaaml-k at th Ilst at 0WG3S for ttm n~ti of HI*<br />
mathod ●id vmm that nudr m ma box --—---- _<br />
0W04ZNG How bnq had mu nnmnd (cumbmahonof mmthods)hen tha one You<br />
us.mltyused, mat mfhe ormYouu-d nIoStaRmr?<br />
Ring the !tUMLWrWh!ChaPplias tO you<br />
Les9 man 3 months<br />
[0]<br />
At kast 3 months lau than6 months [0]<br />
At but 6 months,Iasathan 1 year [01<br />
At least 1 yaw, leg than 2 yearn [0]<br />
At lead 2 YCW3 [0]<br />
[0]<br />
Cmcl<br />
— Go ta 0W39ANY/<br />
DW039<br />
— G.3la 0W47<br />
m<br />
—’atoowxo<br />
— (2a ta 0W43LNG<br />
— Go ta 0W041 MET<br />
— Go to t3VAXZLNG<br />
— Go 100WM3<br />
_ ReturnformM<br />
Inmwmvmr<br />
9 296
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