NATIONAL SURVEY OF FAMILY GROWTH UNDER QUESTIONNAIRE · 2019-07-30 · NATIONAL SURVEY OF FAMILY...

OM8 11: 0937-0104

€xp i res : December 31, 1983

Departmerit o f Hea l th and Human Services

Pub 1 i c Hea l th Serv ice

Nat iona l Center f o r Hea l th S t a t 1 s t i c s

NATIONAL SURVEY OF FAMILY GROWTH CYCLE Ill

UNDER 25 QUESTIONNAIRE

PSU SEG DU

a. Enter from Screener: I I I I 1-1- I I - '-1- I I - 1 2 3 4 5 6 7 8 9

b. ASK R: When were you born? -

CHECK

DIG1 r

BEGIN CARD 02

0 18

I I MONTH DAY YEAR 19-24

c. Enter R's age from screerier and v e r i f y w i t h da te o f b i r t h :

AGE

d. Enter R's m a r i t a l s t a t u s from screener and v e r i f y wi th R:

Cu r ren t l y married. . . . . . . . . . . . . . . . . . . . 1

I n f o r m a l l y mar r ied (no t mar r i ed bu t l i v i n g

together wi th a pa r tne r ) . . . . . . . . . . . . . . . 2

Widowed. . . . . . . . . . . . . . . . . . . . . . . . . 3 Divorced/annul led. . . . . . . . . . . . . . . . . . . . 4

Separated. . . . . . . . . . . . . . . . . . . . . . . . 5

Never marr ied. . . . . . . . . . . . . . . . . . . . . . 6

If age or m a r i t a l s t a t u s does n o t v e r i f y , c o r r e c t and en te r exp lana t ion below. I f R i s 25 or o lde r , use

25 and o l d e r ques t ionna i re .

ASSURANCE OF CONFIDENTIALITY:

In fo rma t ion conta ined on t h i s form which would pe rm i t i d e n t i f i c a t i o n o f any i n d i v i d u a l or estab l i shment has been

c o l l e c t e d wi th a guarantee t h a t i t w i l l be h e l d i n s t r i c t con f idence by t h e c o n t r a c t o r and NCHS, w i l l be used o n l y

f o r purposes s t a t e d i n t h i s study, and w i l l n o t be d i sc losed o r re leased t o anyone o the r than au tho r i zed s t a f f o f

NCHS, w i thout t h e consent o f t h e i n d i v i d u a l or establ ishment i n accordance wi th Sec t ion 308(d) o f t h e P u b l i c Hea l th

Serv ice Act (42 U.S.C. 242m).

PHS-T-492 (Rev . 6-81 )

SECTION A p.m.

Time

What we know about hav ing bab ies and where we learned i t can have an impor tan t e f f e c t on our l i v e s . op in ions , bu t no one i s r e a l l y sure what k i n d s o f i n f o r m a t i o n young people a re g i v e n about sex and c h i l d b e a r i n g or where they a re taught about them.

We hear many

A - I . Would you say t h a t t h e amount o f accura te i n f o r m a t i o n on sex and rep roduc t i on g i ven t o t h e average young person today i s . . .

More than i s needed, . . . . . . . . . . 1 Jus t about r i g h t , . . . . . . . . . . . . . . . . . . . . 2 25 Or not enough? . . . . . . . . . . . 3

A-2. In your own case, have you ever t a l k e d wi th e i t h e r or bo th o f your pa ren ts (be fo re you were 18) about . . . YES NO - -

A. The female monthly c y c l e -- t h a t i s , t h e menstrual cycle?. . . . . I 2 26 B. How pregnancy occurs?. . . . . . . . . . . . . . . . . . 1 2 27 C. Venereal d isease or VD?. . . . . . . . . . . . . . . . . . . . . 1 2 28 D. Methods o f b i r t h con t ro l? . . . . . . . . . . . . . . . 1 2 29

BOX 1. I F R ANSWERED lrNO1l T O ALL I T E M S I N A-2 , G O T O A-4; OTHERWISE, CONTINUE.

A-3. D i d you t a l k about these s u b j e c t s . . . With your mother on ly , . . . . . 1 With your fa the r only, . . . . . . . . . . . . . . . . . 2 With b o t h o f them bu t never when they were together , . . 3 Or with b o t h o f them toge the r , a t l e a s t sometimes? . . . 4

30

ASK A-4 AND A-5 I N SEQUENCE FOR EACH SUBJECT CODED "YES" I N A-4. A-4. (Before you were 18,) d i d you ever have any formal i n s t r u c t i o n on (SUBJECT)?

i n s t r u c t i o n we mean i n s t r u c t i o n g i v e n a t school or as p a r t o f an organized program.) ( I F R ASKS: By formal

FOR EACH "YES" ASK A-5. A-5. A t which o f t h e p laces on t h i s c a r d d i d you ge t formal i n s t r u c t i o n on (SUBJECT)? (CIRCLE ALL THAT APPLY.)

SUBJECT

A. The female monthly cyc le , t h a t i s , t h e menst rua l cyc le?

B. How pregnancy occurs?

C. Venereal d isease or VD?

D. Methods o f b i r t h c o n t r o l ?

A-4

Yes . . . I No. . . . 2

31

Yes . . . 1 No. . . . 2

38

Yes . . . 1 No. . . . 2

45

~ ~~~

Yes . . . 1 N o . . . . 2

( I F NO, GO ro A-7)

52

A-5.

A. Elementary school (grades 1-8) . . . . . . . 1 B. h i g h school (grades 9-12). . . . . . . . . . 1 C. Church or r e l i g i o u s school . . . . . . . . . 1 D. Community cen te r or youth o r g a n i z a t i o n . . . 1 E. Fami ly p lann ing c l i n i c . . . . . . . . 1 F. Some o ther p lace (SPECIFY) 1

A. Elementary school (grades 1-8) . . . . . . . 1 B. High school (grades 9-12). . . . . . . . . . 1 C. Church o r r e l i g i o u s school . . . . . . . . . 1 D. Community cen te r or youth o r g a n i z a t i o n . . 1 E. Fami ly p lann ing c l i n i c . . . . . . 1 F. Some o the r p lace (SPECIFY) 1

A. Elementary school (grades 1-8) . . . . . . . 1 B. High school (grades 9-12). . . . . . . . . . 1 C. Church or r e l i g i o u s school . . . . . . . . . 1 D. Community cen te r or youth o r g a n i z a t i o n . . . 1 E. Fami ly p lann ing c l i n i c . . . . . . . . . . . 1 F. Some o ther p lace (SPECIFY) 1

A. Elementary school (grades 1-8) . . . . . . . 1 B. High school (grades 9-12). . . . . . . . . I C. Church or r e l i g i o u s school . . . . . . . . . 1 D. Community cen te r or youth o r g a n i z a t i o n . . . 1 E. Family p lann ing c l i n i c . . . . . . . 1 F. Some o the r p lace (SPECIFY) 1

32 33 34 35 36 37

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6-12. A t t he t i m e you became pregnant ( f o r the f i r s t t ime) , were you working f u l l - t i m e , working pa r t - t ime , going

t o school , keeping house, or what? (CIRCLE ALL THAT APPLY.)

BOX 5. W A S R L I V I N G W I T H HUSBAND?

Y E S . . . . . . . . . . . . . . . . . . 1 ( B O X 6 )

NO, BUT H A S M E N T I O N E D T H A T S H E W A S

MARRIED A T THE T I M E . . . . . . . . . . . . . 2 (BOX 6 ) N O . . . . . . . . . . . . . . . . . 3 ( 8 - 1 4 )

>

Working f u l l - t i m e (35 hours or more). . . . . . . . . . . . . . . . . 01

Working pa r t - t ime ( 1 t o 34 hours) . . . . . . . . . . . . . . . . . 02

With a j o b but not a t work because o f temporary

Uiemployed, l a i d o f f , l o o k i n g f o r work. . . . . . . . . . . . . . . 04

I n school . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05

Keepinghouse . . . . . . . . . . . . . . . . . . . . . . . . . . - 0 6

m m

i l l n e s s , vacat ion, s t r i k e . . . . . . . . . . . . . . . . . . . . 03 32-33

Other (SPECIFY) 07 34-35

8-13. A t t h e t i m e you became pregnant ( f o r t h e f i r s t t ime) ,

A.

APPLY .)

B.

C. D.

E.

F.

G.

H.

1. J. K.

w i t h whom were you l i v i n g , i f anyone? (CIRCLE ALL THAT

Husband (mar r i ed a t t he t ime) . . . . . . . . . 01

Mother. . . . . . . . . . . . . . . . . . . . 02 F a t h e r . . . . . . . . . . . . . . . 03

Stepfather. . . . . . . . . . . . . . . . 05

m Stepmother. . . . . . . . . . . . . . . . . 04 36-37

Boy f r i end . . . . . . . . . . . . . . . . . . . 06

G i r l f r i e n d ( s ) . . . . . . . . . . . . . . 07

B r o t h e r ( s ) / s i s t e r ( s ) . . . . . . . . . . . . . . 08

Other r e l a t i v e s . . . . . . . . . . . . . . 09

cu 38-39

L i v i n g alone. . . . . . . . . . . . . . . Other (SPECIFY)

40-41

8-14. A t what t ime i n your ( f i r s t ) pregnancy, i f ever, d i d you f i r s t t a l k t o t h e baby's fa the r about t h e f a c t t h a t

you were pregnant? That i s , how many months pregnant were you?

MONTHS

Baby's fa the r never t o l d . . . . . . . . . . 96

0 42

43-44

6-15. A t what t ime i n your ( f i r s t ) pregnancy, i f ever, d i d you f i r s t t a l k t o e i t h e r o f your parents about t h e f a c t

t h a t you were pregnant? That i s , how many months pregnant were you?

MONTHS

Parents never t o l d . . . . . . . . . . 96

47-48

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ALL PREGNANCIES

BOX 7. I F PREGNANCY ENDED BEFORE J A N U A R Y 1 9 7 9 , S K I P T O BOX 8.

I F PREGNANCY ENDED JANUARY 1 9 7 9 O R LATER, C O N T I N U E .

i

6-19. Thinking about your ( Is t /Znd/e tc . ) pregnancy,

i n which o f t h e ways shown on t h i s ca rd d i d

the pregnancy end?

ON B&P RECORD.)

(CIRCLE CODE HERE AND -

1'1

A. S t i l l b i r t h . . . . . . . . . . . . C. Abor t i on . . . . . . . . . . . . . E. B i r t h by normal ( v a g i n a l ) d e l i v e r y

B. Miscar r iage. . . . . . . . . . . . D. B i r t h by Cesarean sec t ion . . . . .

I F MULTIPLE OUTCOME, CIRCLE FIRST OUTCOME

ABOVE AND ENTER LErTER FOR OTHER OUTCOME(S)

ON L I N E . . . . . . . . . . . . . . . . . . . .

6-20. Was t h e baby a boy or a g i r l ?

B o y . . . . . . . . . . . . . . . . . G i r l . . . . . . . . . . . . . . . . . Twins, bo th boys. . . . . . . . . . . Twins, one boy, one g i r l . . . . . . . Twins, bo th g i r l s . . . . . . . . . .

6-21. What d i d you name (her/him)? (ENTER HERE

AND ON B&P RECORD.) -

6-22. On what da te (was [CHILD] bo rn /d id t h a t preg-

nancy end)? (ENTER HERE AND ON B&P RECORD.) -

FIRST

PREGNANCY

. . . . . . . 1 (8-22)

. . . . . . . 2 (8-22)

. . . . . . . 3 (8-22)

. . . . . . . 4 (8-20)

. . . . . . . 5 (8-20)

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . . . . 5

NAME

NAME

I I MO DAY YR

SECOND

PREGNANCY

. . . . . . . 1 (8-22)

. . . . . . . 2 (8-22)

. . . . . . . 3 (8-22)

. . . . . . . 4 (8-20)

. . . . . . . 5 (8-20)

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . * * a 5

NAME

NAME

I I DAY YR

6-23. Dur ing t h i s pregnancy, d i d you ever v i s i t

a doc tor or c l i n i c f o r p r e n a t a l care?

Y e s . . . . . . . No. . . . . . . .

. . . . . . . 1 (6-24)

. . . . . . . 2 ( 6 0 x 8 )

6-24. How many months pregnant were you when you

f i r s t v i s i t e d a doc to r or c l i n i c for p r e n a t a l

care? MONTHS

Current Pregnancy m 75 CODER USE ONLY: L i v e B i r t h s

69-70

Abort i o n s D Tot a1 Pregnancies m 76-77 71 -72

S t i l l b i r t h s / M i s c . rl 73-74 8

. . . . . . . 1 (8-24)

. . . . . . . Z ( B O X 8 )

MONTHS

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8-25. To which o f t h e p laces on t h e c a r d d i d you

go f o r your f i r s t v i s i t ?

8

BOX 8. I F PREGNANCY ENDED I N :

L I V E B IRTH, G O T O 8 - 2 8 , P A G E 1 2 .

ABORTION, G O T O 8 - 3 9 , P A G E 1 8 .

MISCARRIAGE O R S T I L L B I R T H , G O T O 8 - 4 7 , PAGE 2 2 .

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El t.

t .

G.

H.

J.

K.

Community h e a l t h c e n t e r c l i n i c . . P u b l i c h e a l t h department c l i n i c . . A b o r t i o n c l i n i c . . . . . . . . . . Student h e a l t h s e r v i c e c l i n i c . . M i l i t a r y h e a l t h s e r v i c e c l i n i c . . P r i v a t e d o c t o r . . . . . . . . . . P r i v a t e group p r a c t i c e , co-op,

or p r i v a t e c l i n i c . . . . . . . . . Other (SPECIFY). . . . . . . . . .

Fami l y p l a n n i n g c l i n i c . . . . . .

H o s p i t a l c l i n i c . . . . . . . . . .

FIRST

PREGNANCY

. . . . . . . 01

. . . . . . . 0 2

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . 10

SE CO ND

PREGNANCY

. . . . . . . 01

. . . . . . . 0 2

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . I O

I I I 8-26. Between your f i r s t v i s i t and t h e end o f t h e

pregnancy, how o f t e n d i d you v i s i t a doc to r

or c l i n i c f o r p r e n a t a l care? Was i t once

a month or more, or l e s s o f t e n t h a n t h a t ?

Once a month or more. . . . . . . . . Less o f t e n t h a n once a month. . . . . Pregnancy ended wi th in month o f

f i r s t v i s i t . . . . . . . . . . . .

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

8-27. Dur ing your pregnancy, d i d a d o c t o r ever

t e l l you t o remain i n bed f o r one or more

weeks because o f some problem r e l a t e d t o

your pregnancy?

Yes . . . . . . . No. . . . . . . .

. . . . . . . 1

. . . . . . . 2

. . . . . . . 1

. . . . . . . 2

01

60'. "

80

LO 90 50****'**

90 €0

zo 10

A 3NW N3 3tld

HlX IS

01

60 '

80

LO 90 50"" 90 €0 '

ZO""

LO

A 3N W N3 3tl d HljIj

01

60 '

80

LO '

90 50 '

90 €0

10 10

01

60

80

LO 90 50 *

90 €0

zo LO '

A3NWN33tld a8 I HI

LIVE BIRTHS Pregnancy No. I I I Pregnancy No. I I I

FIRST BIRTH SECOND BIRTH

CHILD'S NAME

8-28. How much d i d (CHILD) weigh a t b i r t h ? I (BOX 9 ) I (BOX 9)

oz. oz. LBS. 1 1 LBS.

DK. e, 9898 (8-29) DK. 9898 (8-29)

8-29. D i d (s/he) weigh more than 5 1/2 pounds or l ess?

More . . . . . . . . . . . . . . 1 . . . . . . . 1

5 1 / 2 o r l e s s . . . . . . . . . 2 . . . . . . . 2

I I I BOX 9 . I F CHILD BORN BEFORE JANUARY 1 9 7 9 , S K I P T O BOX I O .

I F CHILD BORN J A N U A R Y 1 9 7 9 O R LATER, CONTINUE. I 8-30. This ca rd l i s t s some o f t h e ways i n which

medical b i l l s can be paid. When (CHILD)

was born, i n which o f these ways was t h e

b i l l pa id? (CIRCLE ALL THAT APPLY AND

PROBE: What o the r ways?)

A. Your ( o r your husband's) own

income. . . . . . . . . . . . . . . . . . . . - 0 1

B. Pa r tne r /boy f r i end or h i s fami ly . . . . . 02

C. Insurance (which you c a r r y or i s c a r r i e d f o r you). . . . . . . .

D. No charge -- p a i d by Medicaid. . . E. Government ass is tance o the r

than Medicaid ( s t a t e or l o c a l ) . . F. M i l i t a r y . . . . . . . . . . . . . G. Parents or o the r r e l a t i v e s . . . . H. Some o the r way (SPECIFY) . . . . .

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 01

. . . . . . . 02

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05 . . . . . . . 06

. . . . . . . 07

. . . . . . . 08

8-37. D i d (CHILD) come home from t h e h o s p i t a l a t t h e

same t ime you d id , or d i d s/he have t o s t a y

longer f o r medical reasons?

Came home w i th mother . . . . . . . . Stayed longer . . . . . . . . . . . . C h i l d g i v e n up for adopt ion . . . . . Not bo rn i n h o s p i t a l . . . . . . . . . C h i l d d i e d a t h o s p i t a l . . . . . . . .

. 0 1 (8-32)

. . 2 (8-32) . . . . . . . 3 (BOX 12,

PAGE 16)

. 4 (8-32)

. . . . . . . 5 (8-36)

1 (B-32)

. . . . . . . 2 (8-32) . . . . . . . 3 (BOX 12,

PAGE 16)

. . . . . . . 4 (8-32)

5 (8-36)

6-32. I n t h e f i r s t s i x months o f (he r /h i s ) l i f e , d i d

you ever take (CHILD) t o t h e doc tor or c l i n i c

f o r a well-baby or r o u t i n e checkup?

Yes . . . . . . . . . . . . . . 1

N O . . . . . . . . . . . . . . . 2 I . . . . . . . 1

. . . . . . . 2

1 2

80 LO 90 50

zo . 10 .

(61-8) 8686 xa 'ZO sa1

(6 X09) I

80******' LO 90 50

zo to

(62-9) 8686 la 'ZO *sa1

(6 XOS) I

90 €0 . 10 '

10 .

(6Z-9) 8686 la 'ZO sa1

(6 X09) I

HltlIB HltlflOA

80 LO 90 40

90 . €0

zoo '

10 .

(6Z-9) 8686 . la zo *sa1

(6 X09) I

-- I I I *ON A3ueu6a4-J

CHILD'S NAME.

8-33. A t b i r t h o r d u r i n g t h e f i r s t year o f ( h e r / h i s )

l i f e , d i d (CHILD) have any o f t he fo l l ow ing

h e a l t h c o n d i t i o n s ? What about . . .

A. Pneumonia or f l u ? . . . . . . . . . B. A l l e r g i e s , such as hay fever ,

asthma, a l l e r g i e s t o pe ts ,

dus t or food?. . . . . . . . . . C. Resp i ra to ry i n f e c t i o n s , such as

b r o n c h i t i s , t o n s i l l i t i s , croup?.

D. Ear i n f e c t i o n s ? . . . . . . . . . . E. D ia r rhea l a s t i n g more than

one day? . . . . . . . . . . . . F. V i tamin d e f i c i e n c i e s o r t o o

l i t t l e weight gain?. . . . . . . G. S k i n diseases such as impet igo ,

ringworm, or scabies?. . . . . . H. I n j u r y , such as, broken bones,

concussion, or acc ident a1

po ison ing? . . . . . . . . . . . born with, or c o n g e n i t a l

cond i t i ons? . . . . . . . . . . . J. Any o the r i l l n e s s e s or c o n d i t i o n s ?

(SPECIFY). . . . . . . . . . . .

1. Hea l th problems t h e c h i l d was

FIRST B I R T H

YES

. . . . . 1

. . . . . I

. . . . . I

. . . . . 1

. . . . . 1

0 . 0 . . 1

. . . . . 1

. . . . . 1

. . . . . 1

. . . . . I

NO

2

-

2

2 2

2

2

2

2

2

2

SECOND B I R r H

YES - . . . . . 1

. . . . . 1

. . . . . 1

. . . . . I

. . . . . 1

. . . . . 1

. . . . . 1

. . . . . I

. . . . . 1

. . . . . 1

NO

2

2

2 2

2

2

2

2

2

2

BOX 1 0 . C H E C K S C R E E N E R . I F CHILD L I V E S I N HOUSEHOLD W I T H R , G O T O 8 - 3 7 .

O T H E R W I S E , C O N T I N U E .

8-34. I see (CHILD) i s no t l i s t e d i n t h e household.

Is (s/he) s t i l l l i v i n g ?

Yes . . . . . . . No. . . . . . . .

8-35. Where i s (s/he) l i v i n g now?

(His/Her) own household . . . . . . . Long te rm c a r e i n s t i t u t i o n . . . . . . A t col lege/away a t schoo l . . . . . . With (h i s /he r ) f a t h e r . . . . . . . . With o the r r e l a t i v e s . . . . . . . . . I n a f o s t e r home. . . . . . . . . . . With adop t i ve pa ren ts . . . . . . . . Other (SPECIFY) . . . . . . . . . . .

6-36. When d i d (s/he) d i e ?

. . 1 (B-35)

. 2 ( 8 - 3 6 )

01 (8-37)

0 02 (8-37)

03 (6-37)

. 04 (8-37)

05 (8-37)

. . 06 (8-37)

. . . . . . . 07 (BOX 12, PAGE 1 6 )

. . . . . . . 08 (8-37)

I MONTH YEAR

. 1 (B-35)

. 2 ( 8 - 3 6 )

. 01 (8-37)

0 2 (8-37)

. 03 (8-37)

04 (8-37)

05 (8-37)

. 06 (8-37)

. . . . . . . 07 (BOX 12, PAGE 1 6 )

08 (8-37)

I MONTH YEAR

BOX 1 1 . I F CHILD D I E D BEFORE T W O M O N T H S OLD, G O T O B O X 1 2 , P A G E 1 6 . O T H E R W I S E , C O N T I N U E .

I b

1 4

UW3A HlNOW

(Lm) 80

‘zi xoa) LO (ma) 90 (ma) 50 (LL-a) vo (ma) LO (Ls-a) zo (ma) to

(91 33Wd

z 1 .***-

z 1 **.’*

z 1 ****-

z 1 ..***

HlNIB HlXIS

UW3A HlNOW

I

(ma) 80

‘zi xoa) LO (Ls-8) 90 (wa) 50 (ma) vo (ma) LO (ma) zo (LL-a) to

(91 33Wd

z 1 **’**

z 1 **-.*

z 1 -**.*

z 1 **.**

UW3A HlNOW

I

(ma) 80

‘11 xoa) LO (Lc-8) 90 (ma) 50 (LL-8) vo (Lm) LO (ma) zo (ma) io

(91 33Wd

z 1 ****.

z 1 *...*

Z -- ON S3A

HlNTB HltlflOA

NW3A HlNOW

(L1-a) 80

‘zt xoa) LO (Lc-8) 90 (Lc-a) 50 (ma) vo (ma) LO (Lm) zo (&a) to

(91 33Wd

z 1 .-***

HlNT8 ClNIHl

CHILD 'S NAME

8-37. When (CHILD) was an i n f a n t , d i d you b reas t feed

(her/nim) a t a l l ?

Y e s . . . . . . .

N o . . . . . . . .

8-38. How many weeks o l d was (s/he) when you stopped

breas t feeding (her/him) a l t oge the r? (RECORD

VERBATIM I F R ANSWERS I N ANYTHING OTHER THAN

WEEKS. 1

FIRST BIRTH

. . . . . . . 1 (B-38)

. . . . . . . 2 (BOX 1 2 )

WEEKS OLD

S t i l l b reas t feeding. . . 96

SECOND BIRTH

. . . . . . . 1 (B-38)

. . . 2 (BOX 12)

WEEKS OLD

S t i l l b reas t feeding. . . 96

BOX 1 2 . I F MORE L I V E B I R T H S FROM T H I S P R E G N A N C Y , R E T U R N T O 8 - 2 8 , PAGE 1 2 .

0 I F R H A S HAD MORE P R E G N A N C I E S OTHER THAN A CURRENT P R E G N A N C Y ,

R E T U R N T O B - 1 9 , PAGE 8 . ( U S E C O N T I N U A T I O N B O O K L E T I F N E C E S S A R Y . )

OTHERWISE, G O r o B - 5 2 , P A G E 2 4 .

r

1 6

HlUI8 HlXIS HltlI8 HljIj

ABORTIONS Pregnancy No. I I I Pregnancy No. I I I

DK. . . . . . . 98 (8-40)

FIRST

ABORT I ON

DK. . . 98 (8-40)

SECOND

ABOR T I ON

1 8 i

8-39 . How many weeks had you been pregnant a t t h e

t ime you had t h e abor t i on?

(8-41)

# OF WEEKS

(8-41 ) 11 OF WEEKS

8-40. Would you say i t was . . . Less than 3 months, . . . . . . . . . 3 t o 6 months,. . . . . . . . . . . . Or more than 6 months?. . . . . . . .

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

8-41. This c a r d l i s t s some o f t he ways i n which

medical b i l l s can be paid. When your preg-

nancy was ended, i n which o f these ways was

the b i l l pa id? (CIRCLE ALL THAT APPLY AND

PROBE: What o the r ways?)

A. Your (ar your husband's) own

income . . . . . . . . . . . . . . 8. Par tne r /boy f r i end or h i s fami ly . . C. Insurance (which you c a r r y

or i s c a r r i e d f o r you) . . . . . . D. No charge -- p a i d by Medicaid. . . E. Government ass is tance o ther

than Medicaid ( s t a t e or l o c a l ) . . F. M i l i t a r y . . . . . . . . . . . . . G. Parents o r o the r r e l a t i v e s . . . . H. Some o the r way (SPECIFY) . . . . .

e . . . . . . 01

0 . . . . . 0 0 2

. . . . . . 03

. . . . . . . 04

. . . . . . 05

. . . . . . . 06

. . . . . . . 07 . . . . . . 08

. . . 0 . 0 . 0 1

. . . 0 . 0 . 0 2

. . . . . 03

. . . . . . . 04

. . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . 08

B-42. Was t h a t pregnancy ended i n . . . A h o s p i t a l or h o s p i t a l c l i n i c , . . . . An a b o r t i o n c l i n i c , . . . . . . . . . Some o the r c l i n i c , . . . . . . . . . . A d o c t o r ' s o f f i ce , . . . . . . . . . . Or some o the r place?. . . . . . . . .

e . . . . . . 1

. . . e . . . 2

. . . . . . . 3

. . . . . . . 4

e . . . . . . 5

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . . . . 5

8-43. Was t h i s (PLACE) l o c a t e d . . . I n your own c i t y or town, . . . . . . In a d i f f e r e n t c i t y or town b u t

i n your own state,. . . . . . . . . Or i n another s ta te? . . . . . . . . .

. . . . . . . 7

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

80

LO***.*oo LO 50

zo . 10. . .

(09-9) 86 xa S133M A0 #

(19-9)

NOT 1 809W

HlXIS

zo 10

(09-9) 86 xa

SI33M A0 #

(19-9)

80 LO 90******* 50

90 €0

20

10. .

(09-9) 86 xa

S133M A0 # (19-9)

NOT 1 809W

HltlllOj

80

LO 90 50

90 €0

20

10 .

(09-9) 86 xa S233M A0 #

(19-a)

NOT 1808W

a8 T HI

FIRST

ABORT I ON

6-44. I n which o f t h e ways on t h i s c a r d d i d you l e a r n

about or were you r e f e r r e d t o t h i s (PLACE)?

(CIRCLE ALL THAT APPLY.)

SECOND

ABOR T I ON

A.

6.

C.

D.

HAND

CARD

9

E.

F.

G. H.

I. J. K.

P r i v a t e d o c t o r or medica l se rv i ce .

Fami ly p lann ing c l i n i c . . . . . . Another k i n d o f c l i n i c . . . . . . School counselor or teacher . . . . Husband, p a r t n e r , or b o y f r i e n d . . (Othe r ) f r i e n d . . . . . . . . . . Parents. . . . . . . . . . . . . . Another r e l a t i v e . . . . . . . . . Newspaper or magazine. . . . . . . Telephone d i r e c t o r y . . . . . . . . Other (SPECIFY). . . . . . . . . .

. . . . . . . O l

. . . . . . . 0 2

. . . . . . . 03

. . . . . . . 04

. . . . . . . 0 5

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . 10

. . . . . . . 11

0 . . . 0 1 . . . . . . . 0 2

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

. . . . . . . 09

. . . . . . . I O . . . . . . . 11

6-45. A t t h i s p lace, b e f o r e t h e a b o r t i o n was done,

d i d a doc to r or o the r t r a i n e d person o f f e r you

counse l i ng or a c t u a l l y t a l k with you about

whether or no t t o s t o p t h e pregnancy?

Y e s . . . . . . . No. . . . . . . .

. . . . . . . 1

. . . . . . . 2

8-46. D i d you r e c e i v e any method of f am i l y p lan -

n i n g or b i r t h c o n t r o l a f t e r t h e a b o r t i o n

from t h i s doc to r or c l i n i c , or were you

r e f e r r e d t o another doc to r or c l i n i c f o r

a method o f f a m i l y p lann ing?

Yes, r e c e i v e d fam i l y p lann ing

Yes, was r e f e r r e d t o another doc to r

No, n e i t h e r r e c e i v e d nor was

method a t t h i s p l a c e . . . . . . . or c l i n i c f o r method . . . . . . . r e f e r r e d f o r a method. . . . . . .

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

I 1 BOX 1 3 . I F R HAS HAD M O R E PREGNANCIES OTHER THAN A CURRENT PREGNANCY,

RETURN T O 6 - 1 9 , PAGE 8. (USE CONTINUATION BOOKLET, I F

NECESSARY.) OTHERWISE, S K I P T O 8 - 5 2 , PAGE 24 .

b I

2 0

MISCARRIAGES OR STILLBIRTHS

FIRST

MISCARRIAGE/STILLBIRTH

Pregnancy No. I I I Pregnancy No. I I I

SECOND

MISCARRIAGE/STILLBIRTH

Or somewhere e l se? (SPECIFY).

B-51. This c a r d l i s t s some o f t h e ways i n which

8-47, How many months had you been pregnant a t t he

t ime you had t h e (miscarriage/stillbirth)?

. . . . . . . . . . . 5 . . . . . . . 5

(8-49

# OF MONTHS

(8-49)

H OF MONTHS

I DK. . . . . . . 98 (8-48) I DK. . . . . . . 98 (8-48) I 8-48. Would you say i t was . . .

Less than 3 months, . . . . . . . . . Or more than 6 months?. . . . . . . . 3 t o 6 months,. . . . . . . . . . . .

. . . . . . . 7

. . . . . . . 2

. . . . . . . 3

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

8-49. A t t h e t i m e o f t h e (miscarriage/stillbirth), what k i n d of medical ca re shown on t h i s ca rd

d i d you have, if any? Jus t t e l l me t h e l e t t e r s

o f t h e k i n d s o f medical ca re you rece ived.


A. A p e l v i c exam. . . . . . . . . . . B. A D&C or scrap ing i n s i d e . . . . . C. A Cesarean s e c t i o n . . . . . . . . D. Induced labo r . . . . . . . . . . . E. An i n j e c t i o n i n t h e abdomen

or b e l l y . . . . . . . . . . . . F. Other (SPECIFY). . . . . . . . . .

None . . . . . . . . . . . . . . . 8-50. D i d you r e c e i v e t h i s medical ca re i n . . .

. 01 (8-50)

02 (B-50)

0 03 (8-50)

0 04 (8-50)

05 (B-50)

. . . . . . . 06 (8-50)

. . . . . . . 96 (BOX 14)

01 (8-50)

. . . . . . . 02 (8-50)

. . . . . . . 04 (B-50)

03 (8-50)

0 . . 05 (B-50)

. . 06 (B-50)

~ ~~~~

. . . . . . . 96 (BOX 14)

A h o s p i t a l or h o s p i t a l c l i n i c , . . . . A t a d o c t o r ' s o f f i c e , . . . . . . . . A t h o m e , . . . . . . . . . . . . . . . Some o the r c l i n i c , . . . . . . . . . .

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

. . . . . . . 1

. . . . . . . 2

. . . . . . . 3

. . . . . . . 4

A. Your (or your husband's) own

i n c o m e . . . . . . . . . . . . . . B. Par tne r /boy f r i end or h i s family. . C. Insurance (which you c a r r y o r

i s c a r r i e d for you). . . . . . . . D. No charge -- p a i d by Medicaid. . . E. Government ass is tance o the r

than Medicaid ( s t a t e o r l o c a l ) . . F. M i l i t a r y . . . . . . . . . . . . . G. Parents or o the r r e l a t i v e s . . . . H. Some o ther way (SPECIFY) . . . . .

. . . . . . . 0 1

. . . . . . . 02

. . . . . . . 03

. . . . . . . 04

. . . . . . . 05

. . . . . . . 06

0 0 07

. . . . . . . 08

. . . . . . . 03

. . 04

. . . . . . . 05

. . . . . . . 06

. . . . . . . 07

. . . . . . . 08

BOX 1 4 . I F R HAS HAD M O R E PREGNANCIES OTHER THAN A CURRENT PREGNANCY, RETURN T O

B -19 , PAGE 8. (USE CONTINUATION BOOKLET, I F NECESSARY.) OTHERWISE,

CONTINUE . 2 2

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(04-9) 90 (05-9) 40

(05-9) 90 (05-8) 50

(05-9) 90 (05-9) 50

(05-9) 90 (04-9) 50

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(89-9) 86 la (89-9) 86 la (89-9) 86 xa (8V-9) 86 '10

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----

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BEGIN CARD 07

18-20 =

8-52. ( In a d d i t i o n t o t h e c h i l d / c h i l d r e n born t o you), have you

adopted any c h i l d r e n ?

Yes. . . . . . . 1 (8-53)

No . . . . . . . 2 (BOX 15) 21

m 8-53. How many c h i l d r e n have you adopted? (ENTER HERE AND

CIRCLE CHILD // I N CHART BELOW 8-54 THROUGH 8-57.)- NUMBER 22-23

ASK 8-54 THROUGH 8-57 I N SEQUENCE FOR EACH ADOPTED CHILD, ENTERING RESPONSES I N TABLE BELOW QUESTIONS,

8-54. Thinking now about the ( f i rs t /second/e tc . ) c h i l d you adopted, what was the c h i l d ' s da te o f b i r t h ?

8-55. What was t h e c h i l d ' s age when you took r e s p o n s i b i l i t y f o r him o r her?

8-56. Before t h e adopt ion, what was t h i s c h i l d ' s r e l a t i o n s h i p t o you, i f any?

8-57. Was he or she born i n t h e Un i ted Sta tes or a f o r e i g n count ry?

B-55. B-56. 8-57. 8-54.

I MO YR 24-27

n m CHILD # I U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 31 U

REL AT I ONSHI P 30 AGE 28-29

n I 17171 m CHILD #2 39

U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 I

REL A T I ONSH I P 38 Mo YR 32-35 AGE 36-37

n I C I I n CHILD 113 47

U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 -

AGE 44-45 Mo YR 40-4 3 REL A T I ONSH I P 46

I cucl U RELATIONSHIP 54

CHILD # 4 55

U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 MO YR 48-51 AGE 52-53

n CHILD #5 U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 63

I MO YR 56-59

~ ~~

RELATIONSHIP 62 AGE 60-61

RE L A T I ONS H I P 70

CHILD %6 71

U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 I

MO YR 64-67 AGE 68-69

n m CHILD #7 79

U.S. . . . . . . . . 1

Fore ign coun t ry . . . 2 U

RELATIONSHIP 78 MO YR 72-75 AGE 76-77

r

BOX 1 5 . I F R HAS NEVER B E E N PREGNANT, S K I P T O S E C T I O N C. O T H E R W I S E , C O N T I N U E .

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3 NOT133S

BEGIN CARD 09

m 13-1 4

PREGNANCIES ENDING BEFORE JANUARY 1979

C-4. Between (A and B) d i d you o r your par tner ever use any method o f b i r t h

c o n t r o l or f am i l y planning for one month or more?

Yes.. . . . . . . . . N o . . . . . . . . . .

C-5. Looking a t the card and s t a r t i n g with the f i r s t method you used between ( A and

B), please t e l l me the l e t t e r f o r each method used f o r one month o r more i n

the order you used them. PROBE: What other methods? (ENTER METHODS I N ORDER

I N THE ANSWER AREA. CIRCLE METHODS ON METHOD CALENDAR.)

CARD

I l1 I C-6. A t the t ime you became pregnant w i t h (B), had you stopped using a l l

methods o f b i r t h c o n t r o l ?

Yes. . . . . . . . . . N o . . . . . . . . . .

~~ ~ ~~

C-7. Was the reason you (had stopped/were no t ) using any method because you

you rse l f wanted t o become pregnant?

Yes. . . . . . . . . . N o . . . . . . . . . .

C-8. A t the t ime you became pregnant with (B) , d i d you you rse l f a c t u a l l y want

t o have a(nother) baby a t some t ime?

Yes. . . . . . . . . . No . . . . . . . . . . Don't know . . . . . .

C-9. It i s sometimes d i f f i c u l t t o r e c a l l these th ings but, as you l o o k back t o

j u s t be fore t h a t pregnancy began, would you say you probably wanted a(nother)

baby a t some t ime or probably no t?

Probably yes . . . . . Probably no. . . . . . Didn ' t care. . . . . .

C-IO. D i d you become pregnant sooner than you wanted, l a t e r than you wanted, or at about the r i g h t t ime?

Sooner . . . . . . . . Later. . . . . . . . . Right t ime . . . . . . Didn ' t care. . . . . .

~~~ ~~ ~ ~~ ~ ~~ ~

C-11. And what about your par tner a t t he t ime you became pregnant w i t h (B), d i d he want t o have a(nother) baby a t some t ime?

Yes. . . . . . . . . . N o . . . . . . . . . . Don't know . . . . . .

C-12. D i d you become pregnant sooner than he wanted, l a t e r than he wanted,

or at about the r i g h t t ime?

Sooner . . . . . . . . Later. . . . . . . . . Right t ime . . . . . . Didn ' t care. . . . . .

Between

A F i r s t In te rcourse

& B

. . . . . . . 1 ( C - 5 )

. . . . . . . 2 (c-7) 18

1 s t

Meth

19-21

2nd

Meth

22-24

3rd

Meth

25-27

Last

Meth

28-30

. . . . . . . 31

1 (C-7)

. . . . . . . 2 (C-8)

. . . . . . . 32

1 ( C - I O )

2 (C-8)

. . . . . . . 1 ( C - I O )

. . . . . . . 2 (c-11) 33

8 (C-9)

. . . . . . . 1 ( C - I O )

. . . . . . . 2 (C-11) 34

. . . . . . . 3 (C-11)

. . . . . . . 1

. . . . . . . 2 7 35 . . . . . . . .

. . . . . . . 4

. . . . . . . 1 (C-12)

. . . . . . . 2 (BOX 18) 36

. . . . . . . 8 (BOX 18)

. . . . . . .

. . . . . . . (BOX 18) 37

1

2

. . . . . . . 3

. . . . . . . 4

2 8

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BOX 1 8 . 0 I F NO A D D I T I O N A L P R E G N A N C I E S , S A Y :

To u n d e r s t a n d a n d c o m p a r e t h e s u c c e s s o f d i f f e r e n t m e t h o d s o f f a m i l y

p l a n n i n g , we a r e t a l k i n g w i t h women i n m o r e d e t a i l a b o u t m e t h o d s

u s e d s i n c e t h e i r l a s t p r e g n a n c y , i f a n y , a n d a b o u t o t h e r m a t t e r s

w h i c h c o u l d a f f e c t t h e n u m b e r o f p r e g n a n c i e s t h e y h a v e a n d when t h e y

h a v e t h e m .

T H E N G O r o c - 3 2 , P A G E 3 7 .

0 I F N E X T P R E G N A N C Y E N D E D :

B E F O R E J A N U A R Y 1 , 1 9 7 9 , R E T U R N TO C - 4 FOR N E X T I N T E R V A L .

0 ON OR S I N C E J A N U A R Y 1, 1 9 7 9 OR I S A C U R R E N T P R E G N A N C Y , S A Y :

To u n d e r s t a n d a n d c o m p a r e t h e s u c c e s s o f d i f f e r e n t m e t h o d s o f

f a m i l y p l a n n i n g , we a r e t a l k i n g w i t h women i n m o r e d e t a i l a b o u t

m e t h o d s u s e d i n t h e l a s t t h r e e y e a r s , i f a n y , a n d a b o u t o t h e r

m a t t e r s w h i c h c o u l d a f f e c t t h e n u m b e r o f p r e g n a n c i e s t h e y h a v e

a n d when t h e y h a v e t h e m .

T H E N GO T O C - 1 5 , P A G E 3 2 .

3 0

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- 01

PREGNANCIES ENDING JANUARY 1979 OR LATER

C-15. Between ( A and B), were t h e r e any pe r iods o f one month o r more i n which you were no t having i n t e r c o u r s e a t a l l , for example, because o f pregnancy, separa t ion , no t d a t i n g anyone, i l l n e s s , or other reasons?

Yes. . . . . . . . . . No . . . . . . . . . .

C-16. What months and years were those? PROBE: What o the r months?

C-17. Between ( A and B), d i d you or your p a r t n e r ever use any method o f b i r t h c o n t r o l or f a m i l y p lann ing f o r one month or more?

Yes. . . . . . . . . . N o . . . . . . . . . .

C-18. Looking a t t h e c a r d and s t a r t i n g with t h e f i r s t method you used between ( A and B), p lease t e l l me the l e t t e r for each method used f o r one month o r more i n t h e order you used them. METHODS I N ORDER I N THE ANSWER AREA. CIRCLE NEW METHODS ON METHOD CALENDAR.)

PROBE: What o the r methods? (ENTER

ASK C-19 THROUGH C-21 I N SEQUENCE FOR EACH METHOD USED I N AN INTERVAL. C-19. Between ( A and B), i n what month and year d i d you s t a r t t o use (METHOD)?

C-20. Dur ing t h e months when you were us ing (METHOD), how many t imes, i f any, d i d you s k i p and no t use any method? Would you say you sk ipped us ing a method . . .

Most times,. . . . . . Often, . . . . . . . . Sometimes, . . . . . . Once or tw ice , . . . . Or, n o t a t a l l ? . . . .

~~ ~~

C-21. I n what month and year d i d you s top us ing (METHOD)?

I BOX 19. I F NO OTHER METHODS USED I N T H I S I N T E R V A L , C O N T I N U E W I T H C - 2 2 . O T H E R W I S E , GO B A C K TO C-19 FOR N E X T METHOD. I

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PREGNANCIES ENDING JANUARY 1979 OR LATER

C-22. I n what month and year d i d you become pregnant w i t h ( B ) ?

I BOX 20. I F NO METHODS USED I N T H I S INTERVAL, G O T O C-24. OTHERWISE, CONTINUE. I C-23. Had you stopped us ing a l l methods b e f o r e you became pregnant? Yes. . . . . . . . . .

N o . . . . . . . . . .

C-24. Was t h e reason you (had stopped/were no t ) us ing any methods because

you y o u r s e l f wanted t o become pregnant?

Yes. . . . . . . . . . N o . . . . . . . . . .

C-25. A t t h e t ime you became pregnant wi th (B ) d i d you, you rse l f , a c t u a l l y

want t o have a(no ther ) baby a t some t ime?

Yes. . . . . . . . . . No . . . . . . . . . . Don ' t know . . . . . .

C-26. I t i s sometimes d i f f i c u l t t o r e c a l l these t h i n g s bu t , as you l o o k back t o j u s t be fore t h a t pregnancy began,

would you say you probab ly wanted a(no ther ) baby a t some t ime or probab ly no t?

Probably yes . . . . . Probably no. . . . . . D i d n ' t care. . . . . .

C-27. D i d you become pregnant sooner than you wanted, l a t e r t han you

wanted, or a t about t h e r i g h t t ime?

Sooner . . . . . . . . Later . . . . . . . . . Right t ime . . . . . . D i d n ' t care. . . . . .

C-28. And what about your p a r t n e r a t t h e t ime you became pregnant wi th (B) ,

d i d he want t o have a(no ther ) baby a t some t ime?

Yes. . . . . . . . . . k.......... Don ' t know . . . . . .

C-29. D i d you become pregnant sooner than he wanted, l a t e r t han he

wanted, or a t about t h e r i g h t t ime?

Sooner . . . . . . . . Later . . . . . . . . . Right t ime . . . . . . D i d n ' t care. . . . . .

B O X 21 . 0 I F M O R E PREGNANCIES SINCE JANUARY 1 , 1 9 7 9 ( I N C L U D I N G A CURRENT PREGNANCY), G O

BACK T O C-15.

I F NO MORE PREGNANCIES AND LAST PREGNANCY I S A CURRENT PREGNANCY, G O T O C-43,

PAGE 39 .

PAGE 37 .

I F NO M O R E PREGNANCIES AND LAST PREGNANCY I S NOT A CURRENT PREGNANCY, G O T O C-32, -

3 4

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C-30. As you t h i n k back, about how long was i t a f t e r your f i r s t in te rcourse u n t i l t he next t ime you had in te rcourse

again?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. 4 t o 6 months. . . . . . . . . . . . . . . . 40

A. Within a month

B. 1 t o 3months. . 2

D. 7 t o 12 months . . . . . . . . . . . . . . . E. More than 12 months. . . . . . . . . . . . .

No second intercourse. . . . . . . . . . . . 6 (C-46, PAGE 40) I BEGIN CARD 12

C-31. Many women have t imes when they are no t having i n te rcou rse a t a l l , f o r example, because o f separation, no t

Since (January 1977/your f i r s t in te rcourse) , please t e l l me the da t ing anyone, i l l n e s s , or other reasons.

per iods o f one month or more, i f any, i n which you were not having i n te rcou rse a t all. months?)

(PROBE: What other

I I MONTH YEAR MONTH YEAR

I I MONTH YEAR MONTH YEAR

I I MONTH YEAR MINTH YEAR

No months o f no intercourse. . . . . . . . . 9696

19-22 23-26

(c-34) m j WI 27-30 31 -34

35-38 39-42

(c-34)

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C-35. Looking again a t the card and s t a r t i n g w i th

the f i r s t method used s ince your ( f i r s t

i n te rcou rse / l as t pregnancy), please t e l l

me the l e t t e r f o r each method used f o r one

month or more, i n the order you used them.

PROBE: What other methods? (ENTER METHODS

I N ORDER I N THE ANSWER AREA. CIRCLE NEW

METHODS ON METHOD CALENDAR.)

ASK C-36 THROUGH C-39 I N SEQUENCE FOR EACH

METHOD MENTIONED.

i n what month and year d i d you s t a r t t o use

(METHOD) ?

C-36. Since your ( f i r s t i n te rcou rse / l as t pregnancy),

1st

Method

u n 20-22

I MO YR --

23-26

2nd

Method

un 33-35

I -- Mo YR

36-39

3rd Method

u n 46-48

I MO YR --

49- 5 2

Last

Method

1171 59-61

I Mo YR --

nn 62-65

I I BOX 2 3 . I F METHOD I S I -- F E M A L E S T E R I L I Z A T I O N , G O T O C - 4 3 . O T H E R W I S E , C O N T I N U E .

C-37. Dur ing t h e months when you were using

(METHOD), how many times, i f any, d i d you

s k i p and no t use any method? Would you say

you skipped using a method . . . Most times, . . . . . . . . . . . . Often,. . . . . . . . . . . . . . . Sometimes,. . . . . . . . . . . . . Once or twice,. . . . . . . . . . . Or, no t a t a l l ? . . . . . . . . . .

. . I

0 . 2

0 . 3 27

0 . 4

0 . 5

. . I

0 . 2

0 . 3 40

0 . 4

0 . 5

0 . 1

0 . 2 0 . 3 53

0 . 4

0 . 5

0 . 1

0 . 2

a . 3 66

0 . 4

0 . 5

BOX 2 4 . I F L A S T METHOD, C O N T I N U E W I T H C - 3 8 . O T H E R W I S E , G O T O C - 3 9 .

28 41 5 4 67 /

C-38. Are you (and your pa r tne r ) s t i l l using

(METHOD)?

Yes. . . . . . . . . . . . 1 (C-42) . . 1 (C-42) . . 1 (C-42) . . 1 (C-42)

No 0 0 0 0 . . 0 0 0 . . 0 2 (C-39) 0 0 2 (C-39) 0 0 2 (c -39) 0 0 2 (c -39)

C-39. I n what month and year d i d you stop using

(METHOD)? YR I MO YR I MO YR I MO YR I Mo

I 29-32 I 42-45 I 55-58 I 68-71

BOX 2 5 . I F ANY OTHER METHODS, G O T O NEXT METHOD, C - 3 6 .

I F R I S I N A P E R I O D OF N O N - I N T E R C O U R S E ( C H E C K C - 3 1 AND C - 3 3 ) , G O T O C - 4 2 .

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REFER TO METHODS CIRCLED ON METHOD CALENDAR. I F NO METHOD CIRCLED, CHECK H E R E O A N D S K I P T O C-46.

OTHERWISE, ASK C-45.

BEGIN CARD 14

C-45. Looking once more a t the l i s t of methods, you have t o l d me t h a t you have used (CIRCLED METHODS). Have I missed any methods you have ever used?

Yes. . . . . . . . . . . . . . . . . . . . . 1 (C-47)

. . . . . . . . . . . . . . . . . . . . . . Z(BOX27)

C-46. Looking once more at t he l i s t o f methods, have you or your par tner ever used a method o f b i r t h c o n t r o l or family planning, even if i t was on ly one t ime?

18

Yes. . . . . . . . . . . . . . . . . . 1 (C-47)

No. . . . . . . . . . . . . . . . . .2 (BOX33 ,PAGE44) 19

C-47. What methods would t h a t be? (CIRCLE ALL THAT APPLY BELOW. I F R MENTIONS THAT A METHOD WAS USED FOR ONE MONTH

OR MORE, CORRECT INTERVAL COLUMNS AND METHOD CALENDAR AS APPLICABLE.)

A. P i l l . . . . . . . . . . . . . . . . . . . . . . - 0 1

B. Condom, rubber . . . . . . . . . . . . . . . . . . 02

C. Foam . . . . . . . . . . . . . . . . . . . . . . . 03

D. J e l l y o r cream, alone. . . . . . . . . . . . . . . 04

E. Suppository o r i n s e r t . . . . . . . . . . . . . . . 05

G. Douching a f t e r in te rcourse . . . . . . . . . . . . 07

H. IUD, c o i l , loop. . . . . . . . . . . . . . . . . . 08

I. Operation - female s t e r i l i z a t i o n . . . . . . . . . 09

J. Operation - male s t e r i l i z a t i o n . . . . . . . . . . 10

K. Natura l f am i l y planning, sa fe per iod by

temperature or c e r v i c a l mucus t e s t . . . . . . . 11 L. Rhythm o r safe per iod by calendar. . . . . . . . . 12

M. Withdrawal/pul l ing out . . . . . . . . . . . . . . 13

N. Abstinence, no t having i n te rcou rse f o r a

m o n t h o r m o r e . . . . . . . . . . . . . . . . . . 14

P. Other (SPECIFY) 15

F. Diaphragm w i t h or without j e l l y o r cream . . . . . 06 m 22-23

BOX 27. S E E METHOD CALENDAR AND C-47. W H A T I S THE TOTAL - NUMBER OF M E T H O D S R H A S E V E R USED?

ONE. . . . . . . . . . . 1 ( B O X 2 8 )

M O R E T H A N ONE. 2 ( C - 4 8 )

BOX 28. I S R ' s ONLY M E T H O D :

D O U C H I N G ( G ) , FEMALE O P E R A T I O N ( I ) , MALE O P E R A T I O N (J), CALENDAR R H Y T H M

( L ) , WITHDRAWAL ( M ) , A B S T I N E N C E ( N ) , O R OTHER ( P ) 1 ( C - 5 0 )

ANY O T H E R METHOD . . . . . . . . . . . . . 2 ( C - 4 9 )

I. I

4 0

0s-62

89-3

32-34

BOX 2 9 . I S C U R R E N T M E T H O D :

N O T CURRENTLY U S I N G A METHOD. . . . . . . . . . . . . . . . . . . . 1 ( B O X 3 1 ) D O U C H I N G ( G ) , FEMALE O P E R A T I O N ( I ) , MALE O P E R A T I O N ( J ) , CALENDAR

R H Y T H M ( L ) , WITHDRAWAL ( M ) , A B S T I N E N C E ( N ) , O R O T H E R ( P I . 0 2 ( B O X 3 1 ) I U D ( H ) , NATURAL FAMILY PLANNING ( K ) . . . . . . . . . . . . . . . . 3 (BOX 3 0 ) ALL O T H E R M E T H O D S 0 0 0 4 ( C - 5 1 )

C-51. From which o f t h e people or p laces on t h i s card d i d you l a s t g e t s u p p l i e s f o r t h e method you are now us ing?

A. P r i v a t e doc tor or medica l serv ice . . . . . . 01 B. C l i n i c . . . . . . . . . . . . . . . . . . - 0 2 C. D r u g s t o r e . . . . . . . . . . . . . . . . . 03 D. Other s to re . . . . . . . . . . . . . . . . . 04

F. G i r l f r i e n d . . . . . . . . . . . . . . . . . 06

G.Parents. . . . . . . . . . . . . . . . . . . 0 7

H. Other (SPECIFY) 08

E. Husband/partner/boyfriend. . . . . . . . . . 05

I 1 I BOX 30. I S C U R R E N T METHOD SAME A S F I R S T METHOD?

YES. . . . . . . . . . . I ( B O X 3 1 ) NO . 2 ( C - 5 2 )

C-52. ( I F CURRENT METHOD IS PILL OR DIAPHRAGM, ASK FOR SOURCE OF PRESCRIPTION.) method you are now us ing, from which o f the people or p laces on t h i s card d i d you ge t ( i t / t h e p r e s c r i p t i o n ) ?

When you s t a r t e d t o use t h e

A.

B.

C.

D.

E.

F.

G. H.

P r i v a t e doc tor or medica l serv ice . . . . . . 01 C l i n i c . . . . . . . . . . . . . . . . . . . 0 2

D r u g s t o r e . . . . . . . . . . . . . . . . - 0 3 Other s to re . . . . . . . . . . . . . . . . . 04

G i r l f r i e n d . . . . . . . . . . . . . . . . . 06

P a r e n t s . . . . . . . . . . . . . . . . . . . 0 7

Other (SPECIFY) 08

Husband/partner/boyfriend. . . . . . . . . . 05

BOX 31. R I S CURRENTLY U S I N G P I L L , G O T O C - 5 3 .

R I S P R E V I O U S P I L L U S E R , G O T O C-54. 0 R N E V E R USED P I L L , G O T O BOX 33.

C-53. You t o l d me t h a t you are us ing t h e p i l l .

v i s i t i n g a doc tor or c l i n i c ?

When d i d you l a s t ge t a w r i t t e n p r e s c r i p t i o n f o r t h e p i l l wh i le

(RECORD VERBATIM ON LINES A T LEFT AND CIRCLE APPROPRIATE CATEGORY.)

6 months o r l e s s . . . . . 1 More than 6 months - 1 year. . . . 2

More than 1 year . 2 years . . . . . . . . . 3 More than 2 years . 3 years. . . . . . . . . 4 More than 3 years. . . . . . . . . . . . . . 5

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C-62. my d i d the doctor say you should stop? (RECORD VERBATIM.) umm 54 55-56 57-58

nmmm 59 60-61 62-63 64-65

1 1 I B O X 33. a I F R N E V E R P R E G N A N T , GO T O BOX 34.

0 I F R E V E R P R E G N A N T , C O N T I N U E . I C-63. There has r e c e n t l y been a grea t deal o f d iscussion about c i g a r e t t e smoking and women's heal th.

age, dur ing your ( l a s t ) pregnancy, how many c i g a r e t t e s per day (did/have) you smoke(d), i f any? On the aver-

About one a day or l ess . . . . . . . . . . . 01

Just a few (2-4) . . . . . . . . . . . . . . 02

About h a l f a pack (5-14) . . . . . . . . . . 03

About a pack (15-24) . . . . . . . . . . . . 04

About 1 1/2 packs (25-34). . . . . . . . . . 05 About 2 packs (35-44). . . . . . . . . . . . 06

More than 2 packs (45+). . . . . . . . . . . 07 Didn ' t smoke dur ing ( l as t / cu r ren t )

pregnancy. . . . . . . . . . . . . . . . 96

C-64. Dur ing your ( l a s t ) pregnancy, how o f t e n (did/do) you usua l l y d r i n k a l coho l i c beverages, t h a t i s , beer,

wine, or l i q u o r ? (Was/Is) i t . . . A. Every day,. . . . . . . . . . . . . . 1

B. A few days a week,. . . . . . . . . . . 2

C. Once a week,. . . . . . . . . . . . . . 3

D. Once a month, . . . . . . . . . . . . . . 4

E. Less than once a month, . . . . . . . . . 5 F a O r n e v e r ? . . . . . . . . . . . . . . . . 6

B O X 34. I F R O R P A R T N E R I S S T E R I L E , G O TO S E C T I O N D. O T H E R W I S E , C O N T I N U E .

C-65. Once they have all t he c h i l d r e n they want, some people s t a r t using a method or change t h e i r method o f fami ly

planning t o be very sure they do no t ge t pregnant again.

t h i n k you w i l l use t o be sure you have no more pregnancies once you have all t he c h i l d r e n you expect t o have? Looking a t the l i s t , which method, if any, do you

CARD WTHOD

66-67

60

69-71

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SECTION D

We are a lso t a l k i n g w i t h women about c h i l d r e n they would l i k e t o have or expect t o have i n t h e fu tu re . ( I F "R" HAS

ALREADY MENTIONED STERILITY OR MENOPAUSE, ETC., SAY: 1 t h i n k we have a l ready t a l k e d about some o f these questions,

but I ' d b e t t e r go through them w i t h you t o be sure 1 r e c o r d the answers c o r r e c t l y . )

BOX 3 5 . I F R I S C U R R E N T L Y PREGNANT, S K I P T O D - 1 5 , PAGE 4 9 .

BEGIN CARD

D-I . Some (couples/women) f i n d i t p h y s i c a l l y imposs ib le t o have (more) c h i l d r e n . As f a r as you know, i s i t

p o s s i b l e or imposs ib le for you (and your husband) t o conceive a(no ther ) baby, t h a t i s , t o g e t pregnant

(again)?

Poss ib le . . . . . . . . . . . . . . . . . 1 (D-15)

Impossib le . . . . . . . . . . . . . . . . . 2 (D-2) 18

Don' t know, n o t sure . . . . . . . . . . . . 8 (D-15)

D-2. Have you (or your husband) had an operat ion, or more than one operat ion, t h a t makes i t imposs ib le for you t o

conceive a(nother) baby ( t o g e t h e r ) ?

19 Yes. . . . . . . . . . . . . . . . . . . . 1 (D-3)

NO . 2 (D-12)

6

D-3. What k i n d o f opera t ion , or operat ions, d i d you (or your husband) have t h a t makes i t imposs ib le t o have

a(nother) baby? (CIRCLE CODE(S) ON TOP OF TABLE ON NEXT PAGE. I F CODE 5 CIRCLED, GO TO BOX 3 6 BELOW.) 0

20

BOX 3 6 .

A . DOES " O T H E R " O P E R A T I O N A F F E C T ONLY ONE TUBE O R O V A R Y ?

Y E S . . . . . . . . . . . . . . . . 1 ( B )

N O . . . . . 2 ( D - 4 )

B. I S R ( O R H U S B A N D ) . . . S T E R I L E FROM T H I S O P E R A T I O N . 1 ( D - 4 )

( O T H E R TUBE O R O V A R Y NOT F U N C T I O N A L )

S T E R I L E FROM ANOTHER O P E R A T I O N . 2 ( 0 - 4 )

S T E R I L E FOR SOME OTHER R E A S O N 3 ( D - 1 2 )

NOT C O M P L E T E L Y S T E R I L E . . 0 4 ( D - 1 5 )

CODER USE ONLY:

D3 D4 D5 D6 D7 D8

21 22-2 5 26 27-28 29-30 31-32 33 34-35 36-37 38-39

40 41 -44 45 46-47 48-49 50-51 52 53-54 55-56 57-58

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D-9. I f i t were p o s s i b l e f o r you t o have a(no ther ) baby, would you, you rse l f , l i k e t o have one?

Y e s . . . . . . . . . . . . . . . . . . . . . l

NO.....................^

BOX 38. H A S R O R HUSBAND HAD BOTH TUBES T IED O R VASECTOMY?

Y E S . . . . . . . . . . 1 ( D - 1 0 )

NO. 2 ( 0 - 3 7 )

D-10. As t h i n g s l o o k t o you j u s t now, i f the opera t i on cou ld be s a f e l y reversed, t h a t i s , changed back, would you

want t o have i t reversed? Would you say . . . D e f i n i t e l y yes . . . . . . . . . . . . . . . 1

Maybe yes, o r . . . . . . . . . . . . . . . . 2

D e f i n i t e l y n o t . . . . . . . . . . . . . . . 3

BOX 39. I S R :

NEVER MARRIED . 1 ( D - 3 7 )

WIDOWED, DIVORCED, SEPARATED. 2 ( D - 3 7 )

CURRENTLY O R INFORMALLY MARRIED 3 ( D - 1 1 )

59

60

D-11. Would your husband l i k e t o have i t reversed? Would you say . . . D e f i n i t e l y yes . . . . . . . . . . . . . . . 1

D e f i n i t e l y n o t . . . . . . . . . . . . . . . 3

Maybe yes, or . . . . . . . . . . . . . . . . 2 ) (D-37) 61

D-12. What i s t h e reason t h a t i t i s p h y s i c a l l y imposs ib le f o r you (and your husband) t o have a(no ther ) baby?

(RECORD VERBATIM, THEN CODE ALL THAT APPLY.)

"R" has reached menopause. . . . . . . . . . 01

Imposs ib le f o r "R" due t o acc ident

o r i l l n e s s . . . . . . . . . . . . . . . . 0 2

"R" s t e r i l e for o the r reasons. . . . . . . . 03

"R" n o t ye t f e r t i l e , pe r iods have

no t s ta r ted . . . . . . . . . . . . . . . . 04

Imposs ib le f o r husband due t o acc ident

o r i l l n e s s . . . . . . . . . . . . . . . . 0 5 Husband s t e r i l e f o r o the r reasons. . . . . . 06

Couple ( o r respondent) unable t o

conceive, do n o t know reason . . . . . . . 07

m 62-63

a 64-65

BOX 40. 0 I F IIR HAS NOT STARTED PERIODS" IS ONLY REASON FOR S T E R I L I T Y , G O T O - INTRODUCTION BEFORE 0 - 2 3 , PAGE 50.

0 OTHERWISE, CONTINUE.

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0-20. W i l l your husband have an o p e r a t i o n t o be sure you d o n ' t become pregnant (again)?

Yes. . . . . . . . . . . . . . . . . . . . . 1 (D-22)

No . 2(D-21) Maybe. . . . . . . . . . . . . . . . . . . . 3(D-21)

76

D-21. I f ( a f t e r t h i s baby i s born) you f i n d t h a t you are pregnant (again) , w i l l you have t h e pregnancy ended by a

doctor for h e a l t h or medica l reasons?

Yes. . . . . . . . . . . . . . . . . . . . . 1 (D-22) No . . . . . . . . . . . . . . . . . . . . . 2 (BOX 42) 77

Maybe.. . . . . . . . . . . . . . . . . . . 3 ( B O X 4 2 )

D-22. I f i t were p o s s i b l e f o r you t o have a(no ther ) baby ( a f t e r t h i s pregnancy), would you y o u r s e l f l i k e t o have

one?

} (0-37) Y e s . . . . . . . . . . . . . . . . . . . . . l ~ . . . . . . . . . . . . . . . . . . . 0 . 2

BOX 4 2 . I F R : I 0 N O T CURRENTLY P R E G N A N T , C O N T I N U E .

e CURRENTLY PREGNANT ( C H E C K B & P R E C O R D ) AND:

0 INTENDING ABORTION, C O N T I N U E .

0 I N T E N D I N G L I V E B I R T H , G O T O INTRODUCTION

BEFORE 0 - 3 0 .

78

NOT CURRENTLY PREGNANT OR CURRENTLY PREGNANT INTENDING ABORTION BEGIN CARD 17

Knowing t h e number o f c h i l d r e n women have now and t h e number they expect t o have i n the f u t u r e i s impor tan t i n

understanding how our p o p u l a t i o n w i l l grow.

w i l l t u r n out , b u t we o f t e n have some ideas about what we i n t e n d t o do.

It i s imposs ib le t o l o o k i n t o t h e f u t u r e and know e x a c t l y how t h i n g s

0-23. Looking t o t h e fu tu re , do you (and your husband) i n t e n d t o have a(nother) baby a t some t ime?

Yes. . . . . . . . . . . . . . . . . . . . . 1 (D-24)

No . . . . . . . . . . . . . . . . . . . . . 2 (D-25) Husband/R disagrees. . . . . . . . . . . . . 3 (D-26)

DK, up t o God, etc.. . . . . . . . . . . . . 8 (D-26)

18

0-24. (Not count ing t h e baby/ ies you have a l ready had), how many (more) do you i n t e n d t o have? [TI No. o f l i v e b i r t h s 19-20

m (D-25)

NUMBER OR RANGE

Don' t know . . . . . . . . . . . . . . . . 98 (D-26) 21 -22

D-25. O f course, sometimes t h i n g s do n o t work ou t e x a c t l y as we i n t e n d them t o , or something makes us change our

minds.

Would you say you are very sure or n o t v e r y sure?

I n your case, how sure are you t h a t you w i l l have (no/NUMBER OR RANGE FROM D-24) (more) bab(y/ ies)?

. . . . . . . . . . . . . . . . I} (BOX 43) 23

V e r y s u r e . .

Not v e r y s u r e . . . . . . . . . . . . . . . . 2

5 0

I

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m I

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0 I

LZ-91

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jaheq oq qaadxa noA saTqeq (yeuorqyppe) 40 Jaqunu qsatreus aqq ST qew *LZ-a

I

jaAeq oq qaadxa nod saiqeq (TeuoTqTppe) 40 Jaqunu qsa6~ey aqq ST qec(M ‘noA ~04 qno YJOM oq s6u~qq qaadxa noA st/ *a~nqnj aqq qnoqe eapT auos aAeq 1TTqs qnq ‘ams q,uaa ardoad AueW ‘92-0

0-33. Many people a ren ' t sure, bu t s t i l l have some idea about the future. what i s the l a r g e s t number o f add i t i ona l babies you expect t o have a f t e r t h i s one i s born?

As you expect t h ings t o work out f o r you,

N o n e . . . . . . . . . . . . . . . . . . .OO(D-37)

NUMBER 0 -34 ) r] 24-2 5

Don't know . . . . . . . . . . . . . . . . 98 (BOX 44)

D-34. What i s t he smal lest number o f add i t i ona l babies you expect t o have a f t e r t h i s one i s born?

NUMBER

Don't know . . . . . . . . . . . . . . . . . 98 26-27

BOX 44. D O E S R I N T E N D T O H A V E M O R E BABIES? ( S E E D-30 O R D -33 )

Y E S . 1 ( D - 3 5 )

NO. . . . 2 ( D - 3 7 )

D O N ' T KNOW. . . . 3 ( D - 3 7 )

0-35. Not count ing your cur ren t pregnancy, how many babies, i f any, do you expect t o have i n the next f i v e years?

NUMBER 28

D-36. A t what age do you expect t o have your l a s t baby?

AGE D

29-30

D-37. The number o f c h i l d r e n people expect i s no t always the same as the number they would most l i k e t o have.

Knowing how o ther th ings are f o r you (and your husband), i f you cou ld choose exac t l y t he number o f c h i l d r e n

t o have i n your whole l i f e , how many would you choose now?

None. . . . . . . . . . . . . . . . . .OO(BOX45)

One. . . . . . . . . . . . . . . . . . . 01 (BOX 45)

More than one:

NUMBER (BOX 45)

RANGE (D-39)

Don't know . . . . . . . . . . . . . . . 98 (D-38)

D 31 -32

a 33-34

~~

0-38. A l o t of people feel t h a t way, but if you cou ld choose, how many would you have?

None. . . . . . . . . . . . . . . . . .OO(BOX45)

One.. . . . . . . . . . . . . . . . . . 0 1 (BOX45)

More than one:

NUMBER (BOX 45)

RANGE (D-39) I Don't know . . . . . . . . . . . . . . . 98 (BOX 45)

5 2

a 35-36

m 37-38

I ‘3flNTlN03 ‘3SIM83H10 ‘19 33Wd ‘A NO1133S 01

03 ‘(aOI83d lS8Ij 33NIS) 3S8fl03831NI QWH 83A3N SWH 8 11 *<9 XO8 I I I

8 38WflN

SECTION E

In t h i s survey, we are a l so t a l k i n g wi th women about f a m i l y p lann ing serv ices . Some women have used these se rv i ces

t o h e l p them become pregnant, and o the rs have used them t o p l a n t h e pregnancies they want, or t o p revent pregnancies

they do no t want.

BEGIN CARD 18

E-I . Have you (or your husband) ever been t o a doc tor or c l i n i c t o t a l k about ways t o h e l p you become pregnant?

Y e s . . . . . . . . . . . . . . . . . . . . . 1

NO.....................^ 18

E-2. (Not count ing r o u t i n e ca re or adv ice about a pregnancy), have you ( o r your husband) ever been t o a doc to r or c l i n i c t o t a l k about ways t o h e l p you prevent a miscar r iage?

Y e s . . . . . . . . . . . . . . . . . . . . . l

NO.....................^

4

BOX 46 . I F NO T O BOTH E-1 AND E-2 , G O T O BOX 47. - O T H E R W I S E , CONTINUE.

19

E-3. What k inds o f medical t rea tment or adv ice have you ( o r your husband) had t o h e l p you (become pregnant/prevent 0 miscar r iage)? (RECORD VERBATIM AND CIRCLE APPROPRIATE CODE.) 20

Respondent on1 y rece ived advice/

t reatment. . . . . . . . . . . . . . . . . 1

Husband on1 y rece ived advice/ 21-24

treatment. . . . . . . . . . . . . . . . . 2

Both rece ived advice/ t reatment . . . . . . . 3

25-28

E-4. When was t h e l a s t t ime you ( o r your husband) v i s i t e d a doc to r or c l i n i c f o r t h i s t rea tment o r advice?

29-32 MONTH YEAR

E-5. To which o f t h e p laces on t h i s ca rd d i d you go f o r t h a t v i s i t ?

A.

B.

C.

D.

E.

F.

G.

H.

I.

Community h e a l t h cen te r c l i n i c .

Pub l i c h e a l t h department c l i n i c

Fami ly p lann ing c l i n i c . . . . . Student h e a l t h s e r v i c e c l i n i c . M i l i t a r y h e a l t h s e r v i c e c l i n i c .

H o s p i t a l c l i n i c . . . . . . . . P r i v a t e doc tor . . . . . . . . . P r i v a t e group p rac t i ce , co-op,

or p r i v a t e c l i n i c . . . . . . Other (SPECIFY)

. 0 . . 0 0 1

. . . . . 02

. . . . . 03

. . . . . 04

. . . . . 05

. . . . . 0 6

. . . . . 0 7

. . . . . 08

09

I 1 BOX 47 . I F R O R HUSBAND BECAME STERILE O R HAD OPERATION BEFORE

JANUARY 1 9 7 9 (SEE D-4, PAGE 4 7 , AND D-13 , PAGE 4 9 ) , G O

T O E -19 , PAGE 58. OTHERWISE, CONTINUE.

33-34

0 35

5 4

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9f7

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6-3

ON ..................... sah

E-11. This ca rd l i s t s the d i f f e r e n t k inds o f counselors , c l i n i c s , and d o c t o r l s o f f i c e s where women may ge t ( t h i s /

these) s e r v i c e ( s ) . I n the past 12 months, t h a t i s , s ince (MONTH/YEAR), a t which o f the p laces on t h i s ca rd

have you rece ived ( t h i s / t h e s e ) fam i l y p lann ing se rv i ce ( s ) ? (CIRCLE ALL THAT APPLY . I F NECESSARY, PROBE BY

READING SERVICES REPORTED I N E-10.)

Counsel or s :

A. M i n i s t e r , p r i e s t , r e l i g i o u s counselor . . . . . . . . 01

C. Fami ly and s o c i a l se rv i ces agency. . . . . . . . . . 03

6. School counselor . . . . . . . . . . . . . . . . . . 02

D. Youth center . . . . . . . . . . . . . . . . . . . . 04

E. Other counselor (SPECIFY) 05

C 1 i n i c s :

F. Hosp i ta l c l i n i c . . . . . . . . . . . . . . . . . . . 06 G. Fami ly p lann ing c l i n i c . . . . . . . . . . . . . . . 07 H. Community h e a l t h center c l i n i c . . . . . . . . . . . 08

I. Abor t ion c l i n i c . . . . . . . . . . . . . . . . . . . 09 I J. Pub l i c h e a l t h department c l i n i c . 10

K. M i l i t a r y h e a l t h se rv i ce c l i n i c . . . . . . . . . . . 11

L. Student h e a l t h se rv i ce c l i n i c . . . . . . . . . . . . 12

M. Other c l i n i c (SPECIFY) 13

. . . . . . . . . .

~

P r i v a t e Medical Serv ices:

N. P r i v a t e doc tor . . . . . . . . . . . . . . . . . . . 14

P. P r i v a t e group p rac t i ce , co-op, or p r i v a t e c l i n i c . . 15

m 55-56

E-12. Dur ing t h e pas t 12 months, how many d i f f e r e n t t imes a l toge the r have you v i s i t e d a counselor , c l i n i c , or doctor

f o r ( t h i s / these ) f a m i l y p lann ing se rv i ce (s )? ( I F NECESSARY, PROBE BY READING SERVICES REPORTED I N E-10.)

One v i s i t . . . . . . . . . . . . . . . . . . 1 (E-15)

Two or more v i s i t s . . . (BOX 49)

NUMBER

BOX 49. I F ONLY ONE K I N D OF PLACE R E P O R T E D I N E - 1 1 , G O T O E-15 .


E-13. How many o f these v i s i t s i n the l a s t 12 months were t o c l i n i c s , such as those l i s t e d under " c l i n i c s " on the

card?

NUMBER

BOX 50. I F NUMBER G I V E N I N E - I 3 EQUALS NUMBER G I V E N I N E - 1 2 , G O T O E - 1 5 .


E-14. How many o f these v i s i t s i n the l a s t 12 months were t o a p r i v a t e d o c t o r ' s o f f i c e or a p r i v a t e medica l

~ p r a c t i c e ?

57-58

0 59

60

0 61

5 6

I

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m 61-81

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.................

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-

E-18. This ca rd l i s t s some o f t he ways i n which medical b i l l s a re paid.

or doctor f o r f a m i l y p lann ing serv ices , i n which o f these ways was the b i l l pa id?

PROBE: In which o f these ways w i l l t h e b i l l be pa id? CIRCLE ALL THAT APPLY AND PROBE: khat o ther ways?)

When you l a s t v i s i t e d a counselor, c l i n i c

( I F BILL HAS NOT BEEN PAID,

A.

B. c.

D. E.

F.

G.

H.

Your

Insurance (which you c a r r y or i s

(o r your husband's) own income . . . 01

Par tner /boy f r iend or h i s fam i l y . . . . . 02

c a r r i e d for you) . . . . . . . . . . . 03 No charge .. p a i d by Medicaid . . . . . . 04

Medicaid ( s t a t e or l o c a l ) . . . . . . . 05

Government ass is tance o ther than

M i l i t a r y . . . . . . . . . . . . . . . . . 06

Parents or other r e l a t i v e s , . . . . . . . 07

Some o ther way (SPECIFY) 08

a 28-29

30-31

m 32-33

E-19. (Th is ca rd l i s t s se rv i ces t h a t are p rov ided t o women f o r t h e i r f a m i l y p lann ing needs.)

a counselor , a c l i n i c or a doc tor for any o f these f a m i l y p lann ing serv ices?

Have you ever v i s i t e d

Yes. . . .................. 1 (E-20)

No 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 ( E - 2 4 )

E-20. Thinking back t o t h e very f i r s t t ime you rece ived any o f the f a m i l y p lann ing se rv i ces on t h i s card,

when was t h a t ?

I (E-21)

MONTH (SEASON) YEAR

Don't know. . . . . . . . . . . . . 9898 (E-20a)

E-20a. How o l d were you a t t h a t t ime?

34

UIn 35-38

AGE 39-40

E-20b. Was i t be fo re your t h b i r t h d a y or a f t e r ?

. . . . . . . . . . . . . . . . . . . . . . 41

B e f o r e . . . I A f t e r . . . . . . . . . . . . . . . . . . . . . . . . . . 2

E-21. A t t h a t f i r s t v i s i t , which o f t he se rv i ces on the card d i d you r e c e i v e ?

descr ibes each s e r v i c e you rece ived a t t h a t f i r s t v i s i t .

Please t e l l me t h e l e t t e r t h a t


Advice or counsel ing on :

A. Any problems or worr ies about sexual i n te rcou rse . 01

B. An unwanted pregnancy or one t h a t occurred a t

a b a d t i m e . . . . . . . . . . . . . . . . . . . . 02

C. Having a s t e r i l i z i n g opera t i on . . . . . . . . . . . 03 D. Whether or not t o have an abor t i on . . . . . . . . . 04

E. Bi r th con t ro l . . . . . . . . . . . . . . . . . . . . 05

Check-up or medica l t e s t f o r : I

F. Correct use, f i t, or p o s i t i o n o f a b i r t h

c o n t r o l method . . . . . . . . . . . . . . . . . . 06 G. Hea l th problems from us ing a b i r t h c o n t r o l

m e t h o d . . . . . . . . . . . . . . . . . . . . . . 07

H. Pregnancy t e s t . . . . . . . . . . . . . . . . . . . 08

I. Renewing an o l d method o f b i r t h c o n t r o l . . . . . . . . . 09

J. Get t i ng a method of b i r t h c o n t r o l . . . . . . . . . . . . 10

44-45

m 46-47

m 48-49

5 8

65

55-v5

a <5-z5

m

15-05

: SJO yasuno3

Never , . . . . . . . . . . . . . . . . 1

Once,. . . . . . . . . . . . . . . . 2

2 - 3 t i m e s t . . . . . . . . . . . . . . . . * 3 Or, more than 3 t imes? . . . . . . . . . . 4

E-26. Have you ever been t r e a t e d i n a d o c t o r ' s o f f i c e , c l i n i c , or emergency room f o r gonorrhea?

Yes. . . . . . . . . . . . . . . * . . - 1

~ . . . . . . . . . . . . . . . . . . . . * 2

- -- ~ L _ _ ~ ~ L ~ ~ _ _ ___ - - ~- x__I--___ -

E-25. H o w many d i f f e r e n t t imes have you been h o s p i t a l i z e d one day or l onger for a p e l v i c i n f e c t i o n ?

say . . Would you

57

58

6 0

91-51

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61

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F.7 . Dur ing t h e t i m e you were growing up. t h a t i s . between t h e ages o f 5 and 15. what was your ( f a t h e r ' s / s t e p -

f a t h e r ' s ) main occupat ion? That i s . what was h i s j o b c a l l e d ? (PROBE FOR DUTIES AND ACTIVITIES.)

D i d n o t l i v e wi th f a t h e r / s t e p f a t h e r

when R was 5.15 . . . . . . . . . . . . . . . . . . 99595

F.8 . What was t h e h i g h e s t grade or year o f r e g u l a r schoo l or c o l l e g e t h a t your (mother/stepmother) completed?

No fo rmal schoo l ing . . . . . . . . . . . . . 00

Elementary

1s t grade . . . . . . . . . . . . . . . . . . 01

2nd grade . . . . . . . . . . . . . . . . . . 02

4 th grade . . . . . . . . . . . . . . . . . . 04

5 th grade . . . . . . . . . . . . . . . . . . 05

6 th grade . . . . . . . . . . . . . . . . . . 06

7 th grade . . . . . . . . . . . . . . . . . . 07

8 th grade . . . . . . . . . . . . . . . . . . 08

3rd grade . . . . . . . . . . . . . . . . . . 03

Hiah School

1s t year . . . . . . . . . . . . . . . . . . 09

2nd year . . . . . . . . . . . . . . . . . . 10

3rd year . . . . . . . . . . . . . . . . . . 11 4 t h y e a r . . . . . . . . . . . . . . . . . . 12

Col lege and Graduate/Profess ional School

1 year . . . . . . . . . . . . . . . . . . . 13

2 y e a r s . . . . . . . . . . . . . . . . . . . 14

4 y e a r s . . . . . . . . . . . . . . . . . . . 16

5 y e a r s . . . . . . . . . . . . . . . . . . . 17

6 years or more . . . . . . . . . . . . . . . 18

3 y e a r s . . . . . . . . . . . . . . . . . . . 15

Don't know . . . . . . . . . . . . . . . . . 98

27-31

32-33

F.9 . When you were growing up. t h a t i s . between t h e ages o f 5 and 15. what k i n d o f work f o r pay. i f any. d i d your

(mother/stepmother) do? That i s . what was her main j o b f o r pay c a l l e d ? (PROBE FOR A C T I V I T I E S OR DUTIES . )

34-38

D i d n o t l i v e wi th mother/stepmother when

Mother/stepmother d i d n o t work f o r pay

Rwas5.15 . . . . . . . . . . . . . . . . . . . - 9 9 5 9 5

when R was 5.15 . . . . . . . . . . . . . . . . . . 99696

6 2

.

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BOX 5 2 . I F R :

NEVER M A R R I E D . . . . . . . . 1 ( B O X 5 7 )

W I D O W E D / S E P A R A T E D / D I V O R C E D 2 ( F - 1 4 )

C U R R E N T L Y O R I N F O R M A L L Y M A R R I E D . 3 ( F - 7 4 )

F-14. ( I n c l u d i n g your present marr iage) , how many t imes have you been marr ied?

U I i/ OF TIMES 51 -52

BOX 5 3 . I F R :

W I D O W E D / D I V O R C E D / S E P A R A T E D . 2 ( F - 1 6 )

C U R R E N T L Y O R I N F O R M A L L Y M A R R I E D . . . 3 ( F - 1 5 )

F-15. When were you and your ( c u r r e n t ) husband marr ied?

( I F INFORMAL UNION, CHECK H E R E 0

AND ENTER DATE.) - I I

MONTH DAY YEAR 53-58

59

BOX 54. I F NO P R E V I O U S M A R R I A G E S , G O T O F - 2 3 . O T H E R W I S E , C O N T I N U E .

6 4

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BEGIN CARD 24 F-23. What was t h e h ighes t grade or year o f r e g u l a r school (or c o l l e g e ) you had completed a t t h e t ime o f your

( f i r s t ) marriage?

No formal school ing. . . . . . . . . . . . . 00

Element a r Y

1st grade.

2nd grade.

3rd grade.

4 th grade.

5th grade.

6 t h grade.

7 t h grade.

8 t h grade.

. . 0 0 . . . . . . . . e . . . . 01

. . . . . . . . . . . . . . . . . 02

. . . . . . . . . . . . . . . . . 03

. . . . . . . . . . . . . . . . . 04

. . . . . . . . . . . . . . . . . 05

. . . . . . . . . . . . . . . . . 06

. * . . . . . . . . . . . . . . . 0 7

. . . . . . . . . . . . . . . . . 08

High School

I s t y e a r . . . . . . . . . . . . . . . . . . 0 9 2 n d y e a r . . . . . . . . . . . . . . . . . . 10

3 r d y e a r . . . . . . . . . . . . . . . . . 11

4 t h y e a r . . . . . . . . . . . . . . . . . . 12

Col lege and Graduate/Profess ional School

1 year . . . . . . . . . . . . . . . . . . . 13

Z y e a r s . . . . . . . . . . . . . . . . . . . 1 4 3 y e a r s . . . . . . . . . . . . . . . . . . . 1 5

4 y e a r s . . . . . . . . . . . . . . . . . 16 5 y e a r s . . . . . . . . . . . . . . . . 17

6 years or more. . . . . . . . . . . . . . 18

BOX 57. NUMBER OF P R E G N A N C I E S E N D I N G I N L I V E B I R T H R H A S HAD ( S E E B & P R E C O R D ) :

NONE . . . . . . . . . . . . 1 ( F - 3 0 )

ONE. 2 ( F - 2 4 )

T W O O R M O R E . 3 ( F - 2 5 )

I

18-19

F-24. Before t h e b i r t h o f your c h i l d , d i d you ever work f o r pay c o n t i n u o u s l y f o r s i x months or more e i t h e r p a r t -

t ime or f u l l - t i m e ?

20 Yes. . . . . . . . . . . . . . . . . . . . . 1 (F-27)

No . . 2 (F-28)

I F-25. Before t h e b i r t h o f your f i r s t c h i l d , d i d you ever work for pay c o n t i n u o u s l y f o r s i x months or more e i t h e r

par t - t ime or f u l l - t ime?

21 Yes. . . . . . . . . . . . . . . . . . . . I ~ . . . . . . . . . . . . . . . . . . . 0 . 2

F-26. D i d you ever work for pay c o n t i n u o u s l y f o r s i x months or more e i t h e r p a r t - t i m e or f u l l - t i m e between t h e

b i r t h o f your f i r s t c h i . l d and t h e b i r t h o f your l a s t c h i l d ?

Yes. . . . . . . . . . . . . . . . . . . . . 1 (F-27) 22

NO . . . 2 ( F - 2 8 )

F-27. How l o n g b e f o r e t h e d e l i v e r y o f your ( l a s t ) c h i l d d i d you s top working? I Less than one month. . . . . . . . . . . . 00

# OF MONTHS

One year or more . . . . . . . . . . . . . . 12 Never stopped/worked r i g h t up t o

d e l i v e r y . . . . . . . . . . . . . . . . . 13

23-24

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F-36. What hours (do /d id ) you u s u a l l y work? (Is/Was) i t . . e (CIRCLE - ONLY ONE CODE.)

A r e g u l a r day s h i f t , . . . . . . . . . . . . 1

A r e g u l a r evening s h i f t , . . . . . . . . . . 2

A r e g u l a r n i g h t s h i f t , . . . . . . . . . . . 3

A s p l i t s h i f t , . . . . . . . . . . . . . . . 4

Or, v a r i a b l e hours?. . . . . . . . . . . 5

F-37. Here i s a card showing amounts o f weekly and y e a r l y earn ings.

earn ings or s a l a r y on t h i s j o b ?

Would you t e l l me which l e t t e r represents your

(ENTER LETTER.)

LETTER

I 1 I BOX 59. I F R HAS OWN, S T E P , O R ADOPTED C H I L D ( R E N ) AGED 0 - 1 2 I N HOUSEHOLD, I ( S E E S C R E E N E R ) , C O N T I N U E . O T H E R W I S E , G O T O F - 4 3 .

I I

42

F-38. (Not count ing r e q u i r e d schoo l attendance), do you have any r e g u l a r arrangement f o r t h e care o f (any o f ) y o u r c h i l d ( r e n ) wh i le you are working, or t a k i n g p a r t i n o ther a c t i v i t i e s o u t s i d e t h e home?

AGED 0-12 DOES NOT COUNT AS CHILD CARE.)

(CARE BY ANOTHER CHILD

1 Yes. . . . . . . . . . . . . . . . . . . . . 1 (BOX 6 0 )

No . 2 ( F - 4 3 )

43-44

0 45

46

47-48

6 8

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B a p t i s t . . . . . . . . . . . . . . . . . . . 21

Lutheran . . . . . . . . . . . . . . . . . . 22

Methodist or Uni ted Methodis t . . . . . . . . 23

Presby ter ian . . . . . . . . . . . . . . . . 24

Ep iscopa l ian . . . . . . . . . . . . . . . . 25

Other P ro tes tan t (SPECIFY) 26

No s p e c i f i c denomination . . . . . . . . . . 28

F.45 . About how o f t e n do you u s u a l l y a t tend r e l i g i o u s serv ices?

Never . . . . . . . . . . . . . . . . . . . . 01

Once a year or l e s s . . . . . . . . . . . . . 02

Several t imes a year . . . . . . . . . . . . 03

Once a m o n t h . . . . . . . . . . . . . . . . 04

2 or 3 t imes a month . . . . . . . . . . . . 05

Onceaweek . . . . . . . . . . . . . . . . . 06

More than once a week . . . . . . . . . . . . 07

1 (F-47)

F.46 . How o f t e n do you r e c e i v e Communion?

Never . . . . . . . . . . . . . . . . . . . . 01

Once a year or l e s s . . . . . . . . . . . . . 02

Several t imes a year . . . . . . . . . . . . 03

Once a m o n t h . . . . . . . . . . . . . . . . 04

2 o r 3 t imes a month . . . . . . . . . . . . 05

Once aweek . . . . . . . . . . . . . . . . . 06

More than once a week . . . . . . . . . . . . 07

F.47 . Which o f t he groups on t h i s card bes t descr ibe your r a c i a l background? (CODE ALL THAT APPLY.)

A . Alaskan n a t i v e or American I n d i a n . . . . . . 1

B . Asian or P a c i f i c I s lander . . . . . . . . . . 2

C . Black . . . . . . . . . . . . . . . . . . . . 3

D . White . . . . . . . . . . . . . . . . . . . . 4

Another group no t l i s t e d (SPECIFY) . . . . . 5

26-27

28-29

30-31

I BOX 62 I F M O R E T H A N ONE CODE CIRCLED I N F.47. A S K F.48 . O T H E R W I S E . G O T O F.49 .

I I

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F.48 . Which o f these groups. t h a t i s (RESPONSES FROM F.47). would you say bes t descr ibes your r a c i a l background?

RACIAL GROUP

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F-52 . What was the h ighes t grade or year o f r e g u l a r school or c o l l e g e your f i r s t husband completed? .. formal school ing . . . . . . . . . . ... Elementary

1st grade . . . . . . . . . . . . . . . . . . 01

2nd grade . . . . . . . . . . . . . . . . . . 02

3rd grade . . . . . . . . . . . . . . . . . . 03

4 t h grade . . . . . . . . . . . . . . . . . . 04

5 th grade . . . . . . . . . . . . . . . . . . 05

6 t h grade . . . . . . . . . . . . . . . . . . 06

7 t h grade . . . . . . . . . . . . . . . . . . 07

8 t h grade . . . . . . . . . . . . . . . . . . 08

High School

1st year . . . . . . . . . . . . . . . . . . 09

2 n d y e a r . . . . . . . . . . . . . . . . . . 10

3rd year . . . . . . . . . . . . . . . . . . 11

4 t h year . . . . . . . . . . . . . . . . . . 12

Col lege and Graduate/Professional School

1 year . . . . . . . . . . . . . . . . . . . 13

2 years . . . . . . . . . . . . . . . . . . . 14

3 years . . . . . . . . . . . . . . . . . . . 15

4 y e a r s . . . . . . . . . . . . . . . . . . . 16

5 y e a r s . . . . . . . . . . . . . . . . . . . 17

6 years or more . . . . . . . . . . . . . . . 18

F.53 . Was your marr iage t o your f i r s t husband h i s f i r s t marr iage. or had he been marr ied before?

F i r s t marr iage . . . . . . . . . . . . . . . 1

Marr ied be fo re . . . . . . . . . . . . . . . 2

F.54 . Was your f i r s t husband Pro tes tan t . Roman Ca tho l i c . Jewish. o r something e l se?

Pro tes tan t . . . . . . . . . . . . . . . . . 1

Roman Ca tho l i c . . . . . . . . . . . . . . . 2

Jewish . . . . . . . . . . . . . . . . . . . 3

Other (SPECIFY) 4

None . . . . . . . . . . . . . . . . . . . . 5 Don' t know . . . . . . . . . . . . . . . . . 8

46-47

48

49

F.55 . And now t h i n k i n g about your ( c u r r e n t / l a s t / f o r m e r ) husband. when was he born?

MONTH DAY YEAR 50-55

Don' t know . . . . . . . . . . . 989898 (F-55a)

F.55a . How o l d was he when you were marr ied?

~~~~~~~~ ~ ~

AGE

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F-61. Last week, was your husband working f u l l - t i m e , par t - t ime, go ing t o school, keeping house, or what? (CIRCLE

ALL THAT APPLY AND FOLLOW S K I P INSTRUCTION FOR SMALLEST CODE CIRCLED.)

m m

(F-63) 64-65

Working f u l l - t i m e (35 hours o r more) . . . . 01

Working pa r t - t ime (1 t o 34 hours) . . . . . . 02

With a j o b but no t a t work because o f

temporary i l l n e s s , vacat ion, s t r i k e . . . . 03

Unemployed, l a i d o f f , l o o k i n g f o r work . . . 04

Keeping house. . . . . . . . . . . . . . . . 07 (F-62) 66-67

I n s c h o o l . . . . . . . . . . . . . . . . . - 0 6

Other (SPECIFY) 08 I

Y e s . . . . . . . . . . . . . . . . . . . . . 1(F-63 )

NO . 2(F-67) 68

F-63. What ( is/was) your husband's (main) occupat ion? That i s , what ( is/was) h i s j o b c a l l e d ?

F-64. What (are/were) h i s most impor tan t a c t i v i t i e s o r d u t i e s ?

F-65. What k i n d o f bus iness or i n d u s t r y (does/d id) he work f o r ? That i s , what (do/did) they make or do?

F-66. What hours (does/d id) he u s u a l l y work? (Is/Was) i t . . . (CIRCLE ONLY ONE CODE.) - A r e g u l a r day s h i f t , . . . . . . . . . . . . 1

A r e g u l a r evening s h i f t , . . . . . . . . . 2 A r e g u l a r n i g h t s h i f t , . . . . . . . . . . . 3 A s p l i t s h i f t , . . . . . . . . . . . . . . . 4

Or, v a r i a b l e hours?. . . . . . . . . . . . . 5

69-73

74

F-67. Here i s a card showing amounts o f weekly and yea r l y incomes.

husband's income i n the pas t 12 months -- t h a t i s , s i n c e (MONTH/YEAR), cons ider ing a l l sources such as wages,

p r o f i t s , i n t e r e s t and so on?

Would you t e l l me which l e t t e r represents your

LETTER I (BOX 6 6 )

Refused. . . . . . . . . . . . . . . . . . 9 7 D o n ' t k n o w . . . . . . . . . . . . . . . . 9 8

75-76

F-68. Was your marr iage t o your ( las t / fo r rner ) husband h i s f i r s t marriage, or had he been mar r ied be fore?

F i r s t marr iage . . . . . . . . . . . . . . . 1 Marr ied be fo re . . . . . . . . . . . . . . . 2

77

7 4

61

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NATIONAL SURVEY OF FAMILY GROWTH UNDER QUESTIONNAIRE · 2019-07-30 · NATIONAL SURVEY OF FAMILY...

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Transcript of NATIONAL SURVEY OF FAMILY GROWTH UNDER QUESTIONNAIRE · 2019-07-30 · NATIONAL SURVEY OF FAMILY...