Questionnaire - Page 6(b) of 9
(1078 maximum possible questions)		 Last updated: Oct 09, 2008

THE ANALYST TM
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These questions are about past pregnancies.
647.  Have you had any miscarriages?
None / don't know
Probably, or too early to be sure
Yes, early in pregnancy
Yes, one later than second month of pregnancy
Two or more after second month
648.  Have you had any ectopic pregnancies?
No / Don't know
It has been suggested but not confirmed
One for sure
Two for sure
More than two
649.  How many intentional abortions have you had?
None / don't know
One
Two
Three
Four or more
650.  How many successful pregnancies have you had?
None / don't know
One
Two
Three
Four or more
651.  If you have had children, how old were you at the birth of your first child?
I don't have children / don't know
Under 17
17-20
21-35
Over 35

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GLOSSARY

Ectopic:  Located outside normal position, e.g., location of fetus in pregnancy.



 


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