1 - ESDS

1 - ESDS 1 - ESDS

24.08.2013 Views

70 THOSE WHO DO NOT USE A METHOD AT THE PRSSENT TIME Hem am some masons tir cd u~g a method. Which‘@y fa you and your huaiw!d/pwlner? ~67EAB W4ntsd to have a bOby. ........... .... ........ ...... ... .. ...... ... . [6} MWQ67 MEN Unlkely to concewebwausa of menopauaa. . ............ . .... m Mwa671NF Unllkalyto concaivabecause~~bla infwflle [2] MWQ67UNS Oo not i+keOXXracapt!onandlorfindmethodundatbfacfoty.... [q MWQS7RSL MWQ670TH Againsltaachicqsof ohurchhmliqrnusM&f ..... ...................... An&har meson........................................................................ P1 [1] Mining .... ..... ......... ........ ... .... ... . ... . ................. ..... [1] Plea- WIit9 yOtlrma- below ....___-. ______ Mwass In the ha 2 yams have you (oryourhuz&nd/parirmr) u$adany of the methodsof preventingpmgnancf Ii@@dMOW at MwQ597 Yes . ... ... ..... .... ........ . . . ... ... .... .. .... ...... .... [q NO . ... .... ... ................ .......... ... ....... ....................... [1s] Missirq ........ . . . . ..... ........... .. ..................... ............... [1] Mwoss If you (or yourhuabmdlpwimr) usedone or morenmthodsin the last 2 years, ring W the numbaf that apply. Wnhdrawl ....... ......... . ......... ... ........ .... .................... [4] Sheawcandom ................................................................. Safa pmiodlrhythmmethad PI [D] C@4iaphngm .................................................................. [q 03nttampfive sponge . . . [0] pin miniml (progwbmn only) .. ........ ........ . . . ......... P] Pin combinedpill(Includingmum.phaaicpill)... .. .. ........ Pllk nQtsum if miniorCambimd [q Pfnsa writo the bmnd nmw below ___________ [0] lUO/c&Uintm-IJfwinadovica .............. ............................... [01 Fowns/geW8piay#~mmias (spennicidea) ..................... [0] Goktgwithnulsexualintwcoumato avoidpmgrmwy ....... [0] Iwbns ....... .................. ............. ......... ....................... [0] AnOfhwmethod Plaau WlitOita name below _____________ [0] Miaiw ... .... ..... .......... .. ... .... . ....... ... . . ....... [4] 14 1Ga toMWXW P?cl ‘Goto MW05S — Returnformto Intmvlewer ‘Goto MkW.XS Total msnbor of UIIN8 ●IINthOd Cwd . n=ll I I I _ Retom formto Intwviewer

70 THOSE WHO DO NOT USE A METHOD AT THE PRSSENT TIME<br />

Hem am some masons tir cd u~g a method. Which‘@y fa you and<br />

your huaiw!d/pwlner?<br />

~67EAB W4ntsd to have a bOby. ........... .... ........ ...... ... .. ...... ... . [6}<br />

MWQ67 MEN<br />

Unlkely to concewebwausa of menopauaa. . ............ . .... m<br />

Mwa671NF<br />

Unllkalyto concaivabecause~~bla infwflle<br />

[2]<br />

MWQ67UNS<br />

Oo not i+keOXXracapt!onandlorfindmethodundatbfacfoty.... [q<br />

MWQS7RSL<br />

MWQ670TH<br />

Againsltaachicqsof ohurchhmliqrnusM&f ..... ......................<br />

An&har meson........................................................................<br />

P1<br />

[1]<br />

Mining .... ..... ......... ........ ... .... ... . ... . ................. ..... [1]<br />

Plea- WIit9 yOtlrma- below ....___-. ______<br />

Mwass In the ha 2 yams have you (oryourhuz&nd/parirmr) u$adany of<br />

the methodsof preventingpmgnancf Ii@@dMOW at MwQ597<br />

Yes . ... ... ..... .... ........ . . . ... ... .... .. .... ...... .... [q<br />

NO . ... .... ... ................ .......... ... ....... ....................... [1s]<br />

Missirq ........ . . . . ..... ........... .. ..................... ............... [1]<br />

Mwoss If you (or yourhuabmdlpwimr) usedone or morenmthodsin the<br />

last 2 years, ring W the numbaf that apply.<br />

Wnhdrawl ....... ......... . ......... ... ........ .... .................... [4]<br />

Sheawcandom .................................................................<br />

Safa pmiodlrhythmmethad<br />

PI<br />

[D]<br />

C@4iaphngm .................................................................. [q<br />

03nttampfive sponge . . . [0]<br />

pin miniml (progwbmn only) .. ........ ........ . . . ......... P]<br />

Pin combinedpill(Includingmum.phaaicpill)... .. .. ........<br />

Pllk nQtsum if miniorCambimd<br />

[q<br />

Pfnsa writo the bmnd nmw below ___________ [0]<br />

lUO/c&Uintm-IJfwinadovica .............. ............................... [01<br />

Fowns/geW8piay#~mmias (spennicidea) ..................... [0]<br />

Goktgwithnulsexualintwcoumato avoidpmgrmwy ....... [0]<br />

Iwbns ....... .................. ............. ......... ....................... [0]<br />

AnOfhwmethod<br />

Plaau WlitOita name below _____________ [0]<br />

Miaiw ... .... ..... .......... .. ... .... . ....... ... . . ....... [4]<br />

14<br />

1Ga toMWXW<br />

P?cl<br />

‘Goto MW05S<br />

— Returnformto<br />

Intmvlewer<br />

‘Goto MkW.XS<br />

Total msnbor of<br />

UIIN8 ●IINthOd<br />

Cwd<br />

. n=ll I<br />

I I<br />

_ Retom formto<br />

Intwviewer

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