1 - ESDS

Quastmmaara Raf mdxng Shaat No of
Q55
Quastaori No Raf ●renca Boxesf Coding InstrnctLons/Rmmarks
Charactara
Q56
(1ST HSTHOD )
Q56
(2ND-4TH METHODS)
I
Q55 LONG
Q56
Q56 (1)
Q56 (2)
Q56 (3)
I
2
2
2
v -3-05
I al”e=
How long has this method
bsan the one you use most
often?
L*SS than 3 manthn ........Ol
At least 3 months, 1--8 than
6 monthm ....... ... .. ....02
At laast 6 monthm, 1-s= than
lyear ..................03
At least 1 ymar, 1-s8 than
2 yeazs ........... .......04
At lmast Zymars .........05
No saxual ralationnhip. ...lB
No method used at all. . ...17
Pregnant ..................19
Withdrawal .......... ......01
Shaath/condcm. ..... .... ...02
Sate pried/rhythm method. 03
Cap/dLaphra~. ...... ......04
Contracmptivo spc.ng=. .....05
Pill: mini pill
(progentaro-only) .......06
Pill: ccaubind pill
(Lncluding multL-phaaic
pill )....................07
PL1l: not sure if rein> or
comkuaed. . ........ ... ....08
10’0/cOll Iintra-utarm*
davlce ............ ... ...09
Fomm/gelm/sprays/~SSarlmS
(aparmicides )............lO
Going without saxual
Lntarcour*m to avo~d
pregnancy ........... .....ll
Inject~ons ......... .......l2
Anothar mathod. ...........13
Values -3-12
Coda as for 1st mathod
(codas 17-19 do not apply) .