1 - ESDS

SWQ38 VWlchof the followingmethod(s)of preventingpregnarcy, If any,
dId you (oryour partner)uwaltj usa mmmdhtely Wore that7
If you had no saxual ralationsh,p. nng [0]
11no nmthod u-d at all. nng [0]
If pu were pregnant. nng [0]
If usually using one or mom methods, nng all th~
numbers that apply
Wtidmvml [0]
Shenth/mndom [0]
Safa pcnodAhythmmethod [0]
Cap/dbphmgm [0]
C0ntmc8ptwesponge [0]
PIN mm PSII(pmg*slemn only) [0!
PIN .wmbmd pdl(Includingmunl-phancpill) [0]
Pill notsura tfmm or combnnd
Pleasa write the brand name below [0]
ltJO/coMtim4mlna dwmrn [0]
Foamwgeb/spmys/p8sanas (q!errmc!dcs) [0]
Goingwrthotis8xual lmtercwumato avotdpragnaw [0]
Injecfbns [01
Anothermathod
Plaaaa w!ite its nammbelow [0]
Rohmad [1]
TO THOSE WISOOID NOT USE A METHOO AT THE TIME OF
BECOMING PREGNANT
Hem Ia a lid of rcmmnswhy paopb do not uaa any mathodhr
pmvenllngprugnancf Winch reasonappbedto you?
SWQ3SBAB Wanfad to hsve a baby [0]
SW39MEN Unlikdy to .wncar#abe.ausa of menopauss [0]
SWQ391NF Unlikelyto .wncewe bacauaa powbtf mfwtlb [0]
SWfXOUNS Don’tIlkecantracaptbn andlor find rinthods
unsdisfactow [1]
SWQS9REL Agamslbachmg of Churcl.hllgmus balieh [0]
SWQ3SOTH Anothermsm
Plmw write your muon below . . . . . - . [1]
Rntimd [1]
SW040 [ntha Ibsf2 yams have you (oryour partnar) used any of the methods
of preventingpmgnancj I#stedat SWQ41?
Yes [2]
No [01
Rofuaod [1]
9
_ Relum formto
lntetvmw*r
— Go to SWQ39
—Gotosmwo
— Go to SWQ41
— Ralum formto
Irsarvlewar
- Ga to SW41
28’2