1 - ESDS
1 - ESDS
1 - ESDS
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0WQ43 Which of the tilbtig mdwd(s) of prewntlng pmgnmcy, if any, did<br />
you (or yourpalner) usmw u- Itm’mdhkly bdom that?<br />
If you had no SOXIUImladonship, ring . . . . . . . .<br />
If no ImathOdUwd ●t all, ring .. . . . . . . . . . . .<br />
If you WGMpmglunt ring .. . . ..-—— ------<br />
If usually tming ona or mom methods, ring ●ll the ntmnbem<br />
that apply<br />
Wlthdmwal..........................................................................<br />
Shnthlccmdom ..................................................................<br />
Sati poriori%hyth method................................................<br />
Ca#dbphmgm . ............ ......................... ....... .................<br />
cOntmG@W SpOngc... ......... ......... . ....... ....................<br />
Pit minipill(pmgoatamnoniy) .......... . . ....... ..... . ....<br />
Pm cambinadpill(irmiudingmuiii.pha@cpill) ...................<br />
Pllkrnt aura if minior combined .......... .............. . ....<br />
PI-- Wti NM brand nams blow ..-----—.<br />
luo/c9Wntm.mwlM *via ......... ... . ............. ...............<br />
Foams/gal#sF4ws!mMtiea (awmioid-) . ....................<br />
0oin9 withoutSOmmliri+ardoumsto avoidpmgtmrwy<br />
Ipns ............... ..................... . ........ ........................<br />
Anothw method<br />
Pleasa write its nana Maw --- . . ..————.._...<br />
TO THOSE wHO OID NOT USE A MEINOO AT YHE TIME OF BECOMING<br />
PREGNANT<br />
Hem is a Ilstof masonawhy psopledo not uas any mernodforpreventing<br />
pregnancy. Wltkh maaon lw~d to you?<br />
0WQ44SAS wanted to haw a baby ........................................ ............. [0]<br />
DWGUMEN unlikelyto concstie beau= of menOp.3ua9...................... [0]<br />
0wY441NF unlikelyto Conwive becaurn posaibFfrnfeftw ...... . .......... [0]<br />
0WQ44UNS Omit Iika cmdmc@lc.n atior Ilnd rrwthoda<br />
Unatlfactov .......... .. ..... ......... .................................... [0]<br />
0WQ44REL Ag8ind tmchings of Chutimligoua belhf .. ...................... [0]<br />
Owauow AnetlwJImm<br />
Plaasa Wlih yOIUmason below ... . . . . . . . . [0]<br />
0WQ4S Inthelast2Yom havayou (oryour pd~er) !$zedany of the matimds<br />
of preventingpregnancyIhted at 0WQ49 on me nexl page?<br />
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Yes ... ... .... . . .... .... ..... . . ..... . ... ....`... .. .... [0]<br />
No .....................................................................................<br />
[0]<br />
10<br />
— Ratom formto<br />
lntwviwmr<br />
—G0t00vm4s<br />
— eatOowMO<br />
— Returnmm! M<br />
m+mvmwar
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