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—<br />

\ Quastlonnaare Ref<br />

Quastlon No<br />

!253<br />

-clang Sheet No of<br />

u-f erance SOxesj cod-g Instructions/Rmmarks<br />

z Characters<br />

1 1<br />

Q53 (4)<br />

[PP]VDuf-2332 Fam Info Sing Worn<br />

Mwfcs<br />

I I I<br />

I<br />

2<br />

I<br />

Valuen -3-13<br />

Usad onm or more methods In<br />

the la-t two years,<br />

Withdrawal ........... .....ol<br />

Shmath/condcin. ......... ...02<br />

Safe parxod/rhythm method. 03<br />

Cap/d ~aphra~. ............04<br />

Contraceptive sponge. .....05<br />

Mini pill (prcqantmrone<br />

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

Combined pill ......... ....O7<br />

Wot suro if mini of<br />

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

IoD/coil /ntra-utmrme<br />

devzcm ............. .. ....09<br />

FOmm/gmlm/mpray m/~anarLee<br />

(s~rmicidas )........ ....10<br />

Goxng without saxual<br />

Intnrceurme to avo~d<br />

pregnancy ............. ...ll<br />

Injections .............. ..l2<br />

Anothar method ......... ...l3<br />

230

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