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Qu.stxonnure Ref<br />

Quastxon No<br />

Q41<br />

Q41<br />

Codang Sheet<br />

Rmfmrmncm<br />

Q41(3)<br />

Q41(4)<br />

No of<br />

SOxmf<br />

Characters<br />

2<br />

2<br />

Cadang Instrmctaons/Remarks<br />

values -3-U<br />

Uaad ono or mors mathods<br />

in tha la-t two yaarm?<br />

Withdrawal ............. 01<br />

Shmat/condun ......... .. 02<br />

Safe ~riodfrhythm<br />

method ........... .. ... 03<br />

Cap/diaphragm .......... 04<br />

C0ntrac0ptiv9 sponge ... 05<br />

Minx PL11 (progostcrone<br />

only) ............. .... 06<br />

Comtuncdp>ll ..... ..... 07<br />

Not sure Lf man~ or<br />

combinad pill ........ . 08<br />

IUD/ coL1/ intra-uterxne<br />

dmv~cm . ......... ...... 09<br />

Foum jgehj ●praysl<br />

pos=arioc -(s~rmiciden) 10<br />

Going without sexual<br />

intarcourso to avozd<br />

pregnmnc y ............. 11<br />

In3actlons ............. 12<br />

Another mathod .... .. .. 13<br />

~ues -3-13<br />

Umod on- or more mmthodn m<br />

the last two ymarm?<br />

W~thdrmwal ............. 01<br />

Sheat/condcm ........... 02<br />

Safe permd/rhythm<br />

method . ............... 03<br />

Cap fdxaphrcqm ...... .... 04<br />

COntraceptLvO ●ponge ... 05<br />

Xmi PL11 (progesterone<br />

only) ............. .... 06<br />

Combined pzll ......... . 07<br />

Not sure Lf mxnl or<br />

combmed PL1l ... ...... 08<br />

In/co~l/Lntra-uterLne<br />

dmv~ce . ............... 09<br />

FOamm/gmls/mpray e./<br />

~ssar>es (●parmic~des ) 10<br />

Co~ng without saxual<br />

ntmrcoursm to avoid<br />

pregnancy ......... .... 11<br />

In2ect10ns ....... ...... 12<br />

Another method ..... ... 13<br />

218

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