1 - ESDS
1 - ESDS
1 - ESDS
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SWQ47 Please put a rtng around the number, opposite the statemant which<br />
applies to you at present<br />
SWG48MET Which mathoddid you u.m m08t otin?<br />
We only used one method [m]<br />
We used momthan one math-adat a time [2]<br />
Sometimeswe u8ad one method,wm.stlmesanother [4]<br />
Refused . . .. . . . . . . . . ... . [2]<br />
Pleasa look ●t the list at SWG46 for the number of the method<br />
and write that number in the box<br />
Pllt Combinedpiii(Includingmuti-phasicF41) [2]<br />
Withdrawal . . . .... .... ... .. [2]<br />
Refused ... . . ... . . . . ... . [2]<br />
SWQ49LNG How longhad this method(C.ambhltlonof methods)ken the<br />
one you ususliyuse, that mthe one you use mo8ttmlen?<br />
Ring the number which applies to you<br />
Less than 3 monms m<br />
At least 3 month less thsn6 months PI<br />
At least6 months,Iesathsn 1 yew ... .... .... ... m<br />
At least 1 year, Iessthan 2y0am . .... .... . .... ..<br />
At leaat2 years ........ . . ..... .. . . .. .... . [1!<br />
Rehmed ..... ........ ..... . .. .. .. .... . ... [2]<br />
Misdng ... . .... . . . . . .. . [1]<br />
SWQ50 Whkh of the followingmethod(s)of preventingpregnancy,if any,<br />
dld you USwliyw kmnadlatRIYb@fOMthSt7<br />
If you had no UXIUI rektlomhip, ring ....... ..... . ....... .<br />
If no M9thod ussd at ●ll, ting ...... ... ..... . ... ....... .... ...<br />
If yau were pregnant, ring .... ... ... .. ..... .............. .. ...<br />
if usually using one or mom methods, ring dl the<br />
numbers thmtapply<br />
Wlthdrswsl . ...... ... ... .. . .. .. . ... .......<br />
ShasWcnmdom ... . .. . . . .. . ... . . ..... .<br />
Sak Pmtodlrhyihmmethod<br />
Catidiaphragm . ... .. .... .. .... .... .....<br />
Conbsmpme sponge ... ..... ... . .... . . .<br />
Pilt miniP!41(pmgostmononly) . ... . . . . . ..<br />
Pllkcombinedpill(Includingmuitkphwsicpill)<br />
PIK not sum if minior combined<br />
Plea- wite the brandname belaw<br />
lUD/cuiUintrautatinadevica .. . . . .<br />
Foams/gels&pmy%/pc8sarias(spermicides)<br />
Goingwthoui s8xualintercourseto avoidpregnmmy<br />
Injections ... . .. . ..... . ... . .. .... .<br />
Anothermethod<br />
Please wrtta its nuns below .................................. ............<br />
Refused . ... .<br />
12<br />
[1s]<br />
[3]<br />
PI<br />
[0]<br />
[3]<br />
[0]<br />
[0]<br />
[0]<br />
[0]<br />
[0]<br />
[1]<br />
[0]<br />
[0]<br />
[0]<br />
[0]<br />
[0]<br />
[2]<br />
— Go to SkWXSLNG<br />
— Go to SW24SMET<br />
_ h to SV@4SLNG<br />
—GOtoswxo<br />
_ Returnformto<br />
Itiewiewvr<br />
— Go to sV#250<br />
I n=27 I<br />
_ Ratum formto<br />
htewiewer<br />
I<br />
— Go to SWR251BAB<br />
“L(+5
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