| Q12-0E [Y01858.00] | Section: Fertility |
([[marital status code ]]=1) & ([[Gender of the respondent]]=1)
COMMENT: is respondent married and is male
| | 1 CONDITION APPLIES ...(Go To Q12-1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-0F [Y01859.00] | Section: Fertility |
([[marital status code ]]!=1) & ([[Gender of the respondent]]=1)
COMMENT: is respondent not married and is male
| | 1 CONDITION APPLIES ...(Go To Q12-1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-1 [] | Section: Fertility |
*************************SECTION 12 FERTILITY*******************************
In order to make future plans for schools, housing, hospitals, and medical
care, information is needed about the number of children people have.
We know that some of these questions may not apply to you, but we need to
ask the same questions of all our respondents in order to be complete.
| Q12-27A [Y01861.00] | Section: Fertility |
Please tell me if you have ever had any children?
| Q12-27B [Y01862.00] | Section: Fertility |
How many children have you had not counting any babies who were dead at birth?
If Answer = 0 Then Go To Q12-27BB
| Q12-27BB [Y01863.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 0)
COMMENT: Is there any child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.1 [] | Section: Fertility |
What did you name your 1st oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.1 [Y01864.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.1 [] | Section: Fertility |
When was your child born?
| Q12-28T.1 [Y01866.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 1)
COMMENT: Is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.2 [] | Section: Fertility |
What did you name the 2nd oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.2 [Y01867.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.2 [] | Section: Fertility |
When was your child born?
| Q12-28T.2 [Y01869.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 2)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.3 [] | Section: Fertility |
What did you name the 3rd oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.3 [Y01870.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.3 [] | Section: Fertility |
When was your child born?
| Q12-28T.3 [Y01872.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 3)
COMMENT: Is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.4 [] | Section: Fertility |
What did you name the 4th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.4 [Y01873.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.4 [] | Section: Fertility |
When was your child born?
| Q12-28T.4 [Y01875.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 4)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.5 [] | Section: Fertility |
What did you name the 5th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.5 [Y01876.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.5 [] | Section: Fertility |
When was your child born?
| Q12-28T.5 [Y01878.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 5)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.6 [] | Section: Fertility |
What did you name the 6th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.6 [Y01879.00] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.6 [] | Section: Fertility |
When was your child born?
| Q12-28T.6 [Y01881.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 6)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.7 [] | Section: Fertility |
What did you name the 7th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.7 [] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.7 [] | Section: Fertility |
When was your child born?
| Q12-28T.7 [] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 7)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.8 [] | Section: Fertility |
What did you name the 8th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.8 [] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.8 [] | Section: Fertility |
When was your child born?
| Q12-28T.8 [] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 8)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.9 [] | Section: Fertility |
What did you name the 9th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.9 [] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.9 [] | Section: Fertility |
When was your child born?
| Q12-28T.9 [] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] > 9)
COMMENT: is there another new child to ask about?
| | 1 CONDITION APPLIES ...(Go To Q12-28.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-28.10 [] | Section: Fertility |
What did you name the 10th oldest baby?
(INTERVIEWER: ENTER FIRST NAME, MIDDLE INITIAL AND LAST NAME.)
| Q12-28A.10 [] | Section: Fertility |
Was the baby a boy or a girl?
| Q12-28B.10 [] | Section: Fertility |
When was your child born?
| Q12-29-A [Y01882.00] | Section: Fertility |
(INTERVIEWER: BELOW IS THE UPDATED CHILD ROSTER IF ANY OF THE INFORMATION
IS INCORRECT PLEASE <PG-UP> AND CORRECT THE ANSWERS TO THE
THE PREVIOUS QUESTIONS)
| Q12-29A-A [Y01883.00] | Section: Fertility |
([[Total number of biological children listed in BIOCHILD roster]] >= 2)
COMMENT: SEE IF THERE ARE AT LEAST 2 KIDS TO ASK ABOUT TWINS
| | 1 CONDITION APPLIES ...(Go To Q12-29C) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-29C [Y01885.00] | Section: Fertility |
(ARE THERE ANY TWINS/TRIPLETS/ETC. LISTED ON THE BIOCHILD ROSTER? ENTER
R'S RESPONSE TO QUESTION FOR PREVIOUS SCREEN.)
| Q12-30.1 [Y01886.00] | Section: Fertility |
CHECK ([Name of biological child(1)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.1 [] | Section: Fertility |
[[Status of biological child (code)(1)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.1
If Answer = 8 Then Go To Q12-44.1
If Answer = 99 Then Go To Q12-30.2
| Q12-30D.1 [Y01888.00] | Section: Fertility |
Where does [Name of biological child(1)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.1) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30DB.1 [Y01889.00] | Section: Fertility |
[[usual residence of biological child(1)]]
COMMENT: Enter code for hhiflag.
If Answer = 1 Then Go To Q12-44.1
If Answer >= 2 AND Answer <= 4 Then Go To Q12-53.1
If Answer >= 6 AND Answer <= 7 Then Go To Q12-53.1
If Answer = 8 Then Go To Q12-30E.1
If Answer = 11 Then Go To Q12-53.1
| Q12-30E.1 [] | Section: Fertility |
When did [Name of biological child(1)] die?
| Q12-44.1 [Y01892.00] | Section: Fertility |
[[usual residence of biological child(1)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.1
If Answer = 5 Then Go To Q12-30.2
If Answer = 8 Then Go To Q12-30.2
If Answer = 9 Then Go To Q12-47.1
If Answer = 10 Then Go To Q12-45.1
| Q12-45.1 [Y01893.00] | Section: Fertility |
Does [Name of biological child(1)]'s natural [mother/father] live in this household?
| Q12-46.1 [Y01894.00] | Section: Fertility |
Is [Name of biological child(1)]'s [mother/father] living?
| Q12-47.1 [Y01895.00] | Section: Fertility |
When did [Name of biological child(1)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.1) |
| Q12-47A.1 [Y01896.01] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(1)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.1 [Y01897.01] | Section: Fertility |
When did [Name of biological child(1)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.1 [Y01898.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(1)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.1 [Y01899.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(1)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(1)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(1)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.2) |
| Q12-52.1 [Y01900.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.1 [Y01901.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(1)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.1 [Y01902.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(1)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(1)] has not been living with you, about how often have you seen [Name of biological child(1)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.1) |
| Q12-55.1 [Y01903.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.1 [Y01904.00] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.1 [Y01905.00] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.1 [Y01906.00] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.1 [Y01907.00] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.1 [Y01908.00] | Section: Fertility |
When did [Name of biological child(1)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.1) |
| | 0 NEVER LIVED WITH R |
| Q12-57.1 [Y01909.00] | Section: Fertility |
(When did [Name of biological child(1)] last live with you?)
ENTER DATE:
| Q12-58.1 [Y01910.00] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(1)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.2 [Y01911.00] | Section: Fertility |
CHECK([Name of biological child(2)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.2 [] | Section: Fertility |
[[Status of biological child (code)(2)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.2
If Answer = 8 Then Go To Q12-44.2
If Answer = 99 Then Go To Q12-30.3
| Q12-30D.2 [Y01913.00] | Section: Fertility |
Where does [Name of biological child(2)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.2) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30DB.2 [Y01914.00] | Section: Fertility |
[[usual residence of biological child(2)]]
COMMENT: Enter code for hhiflag.
If Answer = 1 Then Go To Q12-44.2
If Answer >= 2 AND Answer <= 4 Then Go To Q12-53.2
If Answer >= 6 AND Answer <= 7 Then Go To Q12-53.2
If Answer = 8 Then Go To Q12-30E.2
If Answer = 11 Then Go To Q12-53.2
| Q12-30E.2 [] | Section: Fertility |
When did [Name of biological child(2)] die?
| Q12-44.2 [Y01916.00] | Section: Fertility |
[[usual residence of biological child(2)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.2
If Answer = 5 Then Go To Q12-30.3
If Answer = 8 Then Go To Q12-30.3
If Answer = 9 Then Go To Q12-47.2
If Answer = 10 Then Go To Q12-45.2
| Q12-45.2 [Y01917.00] | Section: Fertility |
Does [Name of biological child(2)]'s natural [mother/father] live in this household?
| Q12-46.2 [Y01918.00] | Section: Fertility |
Is [Name of biological child(2)]'s [mother/father] living?
| Q12-47.2 [Y01919.00] | Section: Fertility |
When did [Name of biological child(2)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.2) |
| Q12-47A.2 [Y01920.00] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(2)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.2 [Y01921.00] | Section: Fertility |
When did [Name of biological child(2)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.2 [Y01922.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(2)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.2 [Y01923.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(2)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(2)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(2)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.3) |
| Q12-52.2 [Y01924.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.2 [Y01925.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(2)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.2 [Y01926.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(2)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(2)] has not been living with you, about how often have you seen [Name of biological child(2)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.2) |
| Q12-55.2 [Y01927.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.2 [Y01928.00] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.2 [Y01929.00] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.2 [Y01930.00] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.2 [Y01931.00] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.2 [Y01932.00] | Section: Fertility |
When did [Name of biological child(2)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.2) |
| | 0 NEVER LIVED WITH R |
| Q12-57.2 [Y01933.01] | Section: Fertility |
(When did [Name of biological child(2)] last live with you?)
ENTER DATE:
| Q12-58.2 [Y01934.00] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(2)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.3 [Y01935.00] | Section: Fertility |
CHECK ([Name of biological child(3)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.3 [] | Section: Fertility |
[[Status of biological child (code)(3)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.3
If Answer = 8 Then Go To Q12-44.3
If Answer = 99 Then Go To Q12-30.4
| Q12-30D.3 [Y01937.00] | Section: Fertility |
Where does [Name of biological child(3)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.3) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.3 [] | Section: Fertility |
When did [Name of biological child(3)] die?
| Q12-44.3 [Y01939.00] | Section: Fertility |
[[usual residence of biological child(3)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.3
If Answer = 5 Then Go To Q12-30.4
If Answer = 8 Then Go To Q12-30.4
If Answer = 9 Then Go To Q12-47.3
If Answer = 10 Then Go To Q12-45.3
| Q12-45.3 [Y01940.00] | Section: Fertility |
Does [Name of biological child(3)]'s natural [mother/father] live in this household?
| Q12-46.3 [Y01941.00] | Section: Fertility |
Is [Name of biological child(3)]'s [mother/father] living?
| Q12-47.3 [Y01942.00] | Section: Fertility |
When did [Name of biological child(3)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.3) |
| Q12-47A.3 [Y01943.01] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(3)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.3 [] | Section: Fertility |
When did [Name of biological child(3)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.3 [Y01944.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(3)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.3 [Y01945.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(3)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(3)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(3)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.4) |
| Q12-52.3 [Y01946.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.3 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(3)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.3 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(3)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(3)] has not been living with you, about how often have you seen [Name of biological child(3)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.3) |
| Q12-55.3 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.3 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.3 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.3 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.3 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.3 [] | Section: Fertility |
When did [Name of biological child(3)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.3) |
| | 0 NEVER LIVED WITH R |
| Q12-57.3 [] | Section: Fertility |
(When did [Name of biological child(3)] last live with you?)
ENTER DATE:
| Q12-58.3 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(3)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.4 [Y01947.00] | Section: Fertility |
CHECK ([Name of biological child(4)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.4 [] | Section: Fertility |
[[Status of biological child (code)(4)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.4
If Answer = 8 Then Go To Q12-44.4
If Answer = 99 Then Go To Q12-30.5
| Q12-30D.4 [Y01949.00] | Section: Fertility |
Where does [Name of biological child(4)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.4) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.4 [] | Section: Fertility |
When did [Name of biological child(4)] die?
| Q12-44.4 [Y01951.00] | Section: Fertility |
[[usual residence of biological child(4)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.4
If Answer = 5 Then Go To Q12-30.5
If Answer = 8 Then Go To Q12-30.5
If Answer = 9 Then Go To Q12-47.4
If Answer = 10 Then Go To Q12-45.4
| Q12-45.4 [Y01952.00] | Section: Fertility |
Does [Name of biological child(4)]'s natural [mother/father] live in this household?
| Q12-46.4 [Y01953.00] | Section: Fertility |
Is [Name of biological child(4)]'s [mother/father] living?
| Q12-47.4 [Y01954.00] | Section: Fertility |
When did [Name of biological child(4)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.4) |
| Q12-47A.4 [Y01955.00] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(4)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.4 [] | Section: Fertility |
When did [Name of biological child(4)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.4 [Y01956.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(4)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.4 [Y01957.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(4)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(4)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(4)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.5) |
| Q12-52.4 [Y01958.00] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.4 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(4)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.4 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(4)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(4)] has not been living with you, about how often have you seen [Name of biological child(4)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.4) |
| Q12-55.4 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.4 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.4 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.4 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.4 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.4 [] | Section: Fertility |
When did [Name of biological child(4)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.4) |
| | 0 NEVER LIVED WITH R |
| Q12-57.4 [] | Section: Fertility |
(When did [Name of biological child(4)] last live with you?)
ENTER DATE:
| Q12-58.4 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(4)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.5 [Y01959.00] | Section: Fertility |
CHECK ([Name of biological child(5)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.5 [] | Section: Fertility |
[[Status of biological child (code)(5)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.5
If Answer = 8 Then Go To Q12-44.5
If Answer = 99 Then Go To Q12-30.6
| Q12-30D.5 [Y01961.00] | Section: Fertility |
Where does [Name of biological child(5)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.5) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.5 [] | Section: Fertility |
When did [Name of biological child(5)] die?
| Q12-44.5 [Y01963.00] | Section: Fertility |
[[usual residence of biological child(5)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.5
If Answer = 5 Then Go To Q12-30.6
If Answer = 8 Then Go To Q12-30.6
If Answer = 9 Then Go To Q12-47.5
If Answer = 10 Then Go To Q12-45.5
| Q12-45.5 [Y01964.00] | Section: Fertility |
Does [Name of biological child(5)]'s natural [mother/father] live in this household?
| Q12-46.5 [Y01965.00] | Section: Fertility |
Is [Name of biological child(5)]'s [mother/father] living?
| Q12-47.5 [Y01966.00] | Section: Fertility |
When did [Name of biological child(5)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.5) |
| Q12-47A.5 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(5)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.5 [] | Section: Fertility |
When did [Name of biological child(5)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.5 [Y01967.00] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(5)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.5 [Y01968.00] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(5)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(5)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(5)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.6) |
| Q12-52.5 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.5 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(5)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.5 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(5)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(5)] has not been living with you, about how often have you seen [Name of biological child(5)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.5) |
| Q12-55.5 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.5 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.5 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.5 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.5 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.5 [] | Section: Fertility |
When did [Name of biological child(5)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.5) |
| | 0 NEVER LIVED WITH R |
| Q12-57.5 [] | Section: Fertility |
(When did [Name of biological child(5)] last live with you?)
ENTER DATE:
| Q12-58.5 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(5)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.6 [Y01969.00] | Section: Fertility |
CHECK ([Name of biological child(6)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.6 [] | Section: Fertility |
[[Status of biological child (code)(6)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.6
If Answer = 8 Then Go To Q12-44.6
If Answer = 99 Then Go To Q12-30.7
| Q12-30D.6 [Y01971.00] | Section: Fertility |
Where does [Name of biological child(6)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.6) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.6 [] | Section: Fertility |
When did [Name of biological child(6)] die?
| Q12-44.6 [Y01973.00] | Section: Fertility |
[[usual residence of biological child(6)]]
COMMENT: Does first biological child live in household or with another person
part time?
If Answer = 1 Then Go To Q12-45.6
If Answer = 5 Then Go To Q12-30.7
If Answer = 8 Then Go To Q12-30.7
If Answer = 9 Then Go To Q12-47.6
If Answer = 10 Then Go To Q12-45.6
| Q12-45.6 [Y01974.00] | Section: Fertility |
Does [Name of biological child(6)]'s natural [mother/father] live in this household?
| Q12-46.6 [] | Section: Fertility |
Is [Name of biological child(6)]'s [mother/father] living?
| Q12-47.6 [] | Section: Fertility |
When did [Name of biological child(6)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.6) |
| Q12-47A.6 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(6)]'S
NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.6 [] | Section: Fertility |
When did [Name of biological child(6)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.6 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(6)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.6 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(6)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(6)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(6)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.7) |
| Q12-52.6 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.6 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(6)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.6 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(6)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(6)] has not been living with you, about how often have you seen [Name of biological child(6)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.6) |
| Q12-55.6 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.6 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.6 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.6 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.6 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.6 [] | Section: Fertility |
When did [Name of biological child(6)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.6) |
| | 0 NEVER LIVED WITH R |
| Q12-57.6 [] | Section: Fertility |
(When did [Name of biological child(6)] last live with you?)
ENTER DATE:
| Q12-58.6 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(6)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.7 [Y01975.00] | Section: Fertility |
CHECK ([Name of biological child(7)])
COMMENT: Check the name field to determine if there is a child to ask about
| | 1 CONDITION APPLIES ...(Go To Q12-30C.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-30C.7 [] | Section: Fertility |
[[Status of biological child (code)(7)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.7
If Answer = 8 Then Go To Q12-44.7
If Answer = 99 Then Go To Q12-30.8
| Q12-30D.7 [] | Section: Fertility |
Where does [Name of biological child(7)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.7) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.7 [] | Section: Fertility |
When did [Name of biological child(7)] die?
| Q12-44.7 [] | Section: Fertility |
[[usual residence of biological child(7)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.7
If Answer = 5 Then Go To Q12-30.8
If Answer = 8 Then Go To Q12-30.8
If Answer = 9 Then Go To Q12-47.7
If Answer = 10 Then Go To Q12-45.7
| Q12-45.7 [] | Section: Fertility |
Does [Name of biological child(7)]'s natural [mother/father] live in this household?
| Q12-46.7 [] | Section: Fertility |
Is [Name of biological child(7)]'s [mother/father] living?
| Q12-47.7 [] | Section: Fertility |
When did [Name of biological child(7)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.7) |
| Q12-47A.7 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(7)]'S NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.7 [] | Section: Fertility |
When did [Name of biological child(7)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.7 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(7)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.7 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(7)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(7)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(7)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.8) |
| Q12-52.7 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.7 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(7)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.7 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(7)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(7)] has not been living with you, about how often have you seen [Name of biological child(7)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.7) |
| Q12-55.7 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.7 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.7 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.7 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.7 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.7 [] | Section: Fertility |
When did [Name of biological child(7)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.7) |
| | 0 NEVER LIVED WITH R |
| Q12-57.7 [] | Section: Fertility |
(When did [Name of biological child(7)] last live with you?)
ENTER DATE:
| Q12-58.7 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(7)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.8 [] | Section: Fertility |
CHECK ([Name of biological child(8)])
COMMENT: Check the name field to determine if there is a child to ask about
If Answer = 1 Then Go To Q12-30C.8
| Q12-30C.8 [] | Section: Fertility |
[[Status of biological child (code)(8)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.8
If Answer = 8 Then Go To Q12-44.8
If Answer = 99 Then Go To Q12-30.9
| Q12-30D.8 [] | Section: Fertility |
Where does [Name of biological child(8)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.8) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.8 [] | Section: Fertility |
When did [Name of biological child(8)] die?
| Q12-44.8 [] | Section: Fertility |
[[usual residence of biological child(8)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.8
If Answer = 5 Then Go To Q12-30.9
If Answer = 8 Then Go To Q12-30.9
If Answer = 9 Then Go To Q12-47.8
If Answer = 10 Then Go To Q12-45.8
| Q12-45.8 [] | Section: Fertility |
Does [Name of biological child(8)]'s natural [mother/father] live in this household?
| Q12-46.8 [] | Section: Fertility |
Is [Name of biological child(8)]'s [mother/father] living?
| Q12-47.8 [] | Section: Fertility |
When did [Name of biological child(8)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.8) |
| Q12-47A.8 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(8)]'S NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.8 [] | Section: Fertility |
When did [Name of biological child(8)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.8 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(8)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.8 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(8)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(8)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(8)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.9) |
| Q12-52.8 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.8 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(8)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.8 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(8)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(8)] has not been living with you, about how often have you seen [Name of biological child(8)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.8) |
| Q12-55.8 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.8 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.8 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.8 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.8 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.8 [] | Section: Fertility |
When did [Name of biological child(8)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.8) |
| | 0 NEVER LIVED WITH R |
| Q12-57.8 [] | Section: Fertility |
(When did [Name of biological child(8)] last live with you?)
ENTER DATE:
| Q12-58.8 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(8)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.9 [] | Section: Fertility |
CHECK ([Name of biological child(9)])
COMMENT: Check the name field to determine if there is a child to ask about
If Answer = 1 Then Go To Q12-30C.9
| Q12-30C.9 [] | Section: Fertility |
[[Status of biological child (code)(9)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.9
If Answer = 8 Then Go To Q12-44.9
If Answer = 99 Then Go To Q12-30.10
| Q12-30D.9 [] | Section: Fertility |
Where does [Name of biological child(9)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.9) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.9 [] | Section: Fertility |
When did [Name of biological child(9)] die?
| Q12-44.9 [] | Section: Fertility |
[[usual residence of biological child(9)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.9
If Answer = 5 Then Go To Q12-30.10
If Answer = 8 Then Go To Q12-30.10
If Answer = 9 Then Go To Q12-47.9
If Answer = 10 Then Go To Q12-45.9
| Q12-45.9 [] | Section: Fertility |
Does [Name of biological child(9)]'s natural [mother/father] live in this household?
| Q12-46.9 [] | Section: Fertility |
Is [Name of biological child(9)]'s [mother/father] living?
| Q12-47.9 [] | Section: Fertility |
When did [Name of biological child(9)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.9) |
| Q12-47A.9 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(9)]'S NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.9 [] | Section: Fertility |
When did [Name of biological child(9)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.9 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(9)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.9 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(9)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(9)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(9)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-30.10) |
| Q12-52.9 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.9 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(9)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.9 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(9)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(9)] has not been living with you, about how often have you seen [Name of biological child(9)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.9) |
| Q12-55.9 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.9 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.9 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.9 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.9 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.9 [] | Section: Fertility |
When did [Name of biological child(9)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.9) |
| | 0 NEVER LIVED WITH R |
| Q12-57.9 [] | Section: Fertility |
(When did [Name of biological child(9)] last live with you?)
ENTER DATE:
| Q12-58.9 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(9)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-30.10 [] | Section: Fertility |
CHECK ([Name of biological child(10)])
COMMENT: Check the name field to determine if there is a child to ask about
If Answer = 1 Then Go To Q12-30C.10
| Q12-30C.10 [] | Section: Fertility |
[[Status of biological child (code)(10)]]
COMMENT: Check the status of the child. if deceased or deleted, or adopted out
skip to the next child. If the child is added, skip to appropriate
question
If Answer = 5 Then Go To Q12-44.10
If Answer = 8 Then Go To Q12-44.10
If Answer = 99 Then Go To Q12-74.1
| Q12-30D.10 [] | Section: Fertility |
Where does [Name of biological child(10)] usually live?
| | 1 IN THIS HOUSEHOLD |
| | 2 WITH (HIS/HER) (FATHER/MOTHER) |
| | 3 WITH OTHER RELATIVES (SPECIFY) |
| | 4 WITH FOSTER CARE |
| | 5 WITH ADOPTIVE PARENTS |
| | 6 LONG TERM CARE INSTITUTION |
| | 7 AWAY AT SCHOOL |
| | 8 DECEASED ...(Go To Q12-30E.10) |
| | 9 PART-TIME WITH R, PART-TIME WITH OTHER PARENT |
| | 10 PART-TIME WITH R, PART-TIME WITH OTHER PERSON |
| | 11 OTHER (SPECIFY) |
| Q12-30E.10 [] | Section: Fertility |
When did [Name of biological child(10)] die?
| Q12-44.10 [] | Section: Fertility |
[[usual residence of biological child(10)]]
COMMENT: skip according to resident status of child
If Answer = 1 Then Go To Q12-45.10
If Answer = 5 Then Go To Q12-74.1
If Answer = 8 Then Go To Q12-74.1
If Answer = 9 Then Go To Q12-47.10
If Answer = 10 Then Go To Q12-45.10
| Q12-45.10 [] | Section: Fertility |
Does [Name of biological child(10)]'s natural [mother/father] live in this household?
| Q12-46.10 [] | Section: Fertility |
Is [Name of biological child(10)]'s [mother/father] living?
| Q12-47.10 [] | Section: Fertility |
When did [Name of biological child(10)]'s natural [mother/father] leave the household?
| | 1 SELECT TO ENTER DATE |
| | 2 NATURAL (MOTHER/FATHER) NEVER LIVED IN THIS HOUSEHOLD ...(Go To Q12-50.10) |
| Q12-47A.10 [] | Section: Fertility |
INTERVIEWER: ENTER MONTH AND YEAR [Name of biological child(10)]'S NATURAL [mother/father] LEFT THE HOUSEHOLD.
| Q12-48.10 [] | Section: Fertility |
When did [Name of biological child(10)]'s natural [mother/father] die?
(INTERVIEWER: ENTER MONTH AND YEAR.)
| Q12-50.10 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(10)]'s [mother/father] live? Is it...
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-51.10 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often has [Name of biological child(10)] seen (his/her) [mother/father]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(10)] has been separated from (his/her) [mother/father], about how often has [Name of biological child(10)] seen (his/her) [mother/father]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-74.1) |
| Q12-52.10 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-53.10 [] | Section: Fertility |
(HAND CARD AA) About how far from you does [Name of biological child(10)] live? Is it....
| | 1 Within 1 mile |
| | 2 1-10 Miles |
| | 3 11-100 Miles |
| | 4 101-200 Miles |
| | 5 More than 200 Miles |
| Q12-54.10 [] | Section: Fertility |
(HAND CARD BB) In the past 12 months, about how often have you seen [Name of biological child(10)]? (IF SEPARATION IS MORE RECENT THAN PAST 12 MONTHS, ASK:) Since [Name of biological child(10)] has not been living with you, about how often have you seen [Name of biological child(10)]?
| | 1 Almost every day |
| | 2 2-5 times a week |
| | 3 About once a week |
| | 4 1-3 times a month |
| | 5 7-11 times in past 12 months |
| | 6 2-6 times in past 12 months |
| | 7 Once in past 12 months |
| | 0 Never ...(Go To Q12-55A.10) |
| Q12-55.10 [] | Section: Fertility |
How long do these visits usually last?
(INTERVIEWER: ENTER NUMBER OF DAYS. IF LESS THAN 1 DAY, ENTER 00.)
| Q12-55A.10 [] | Section: Fertility |
Are you contributing money for the child's upbringing now?
| Q12-55B.10 [] | Section: Fertility |
Do you do this on a regular basis or once in a while?
| | 1 Regular |
| | 2 Once in a while |
| Q12-55C.10 [] | Section: Fertility |
How much do you give?
(INTERVIEWER : NEXT QUESTION ASKS FOR UNIT)
ENTER DOLLAR AMOUNT:
| Q12-55D.10 [] | Section: Fertility |
Is that per week, per month or per year?
| | 4 Per Week |
| | 1 Per month |
| | 2 Per year |
| | 3 OTHER (SPECIFY) |
| Q12-56.10 [] | Section: Fertility |
When did [Name of biological child(10)] last live with you?
| | 1 SELECT TO ENTER DATE ...(Go To Q12-57.10) |
| | 0 NEVER LIVED WITH R |
| Q12-57.10 [] | Section: Fertility |
(When did [Name of biological child(10)] last live with you?)
ENTER DATE:
| Q12-58.10 [] | Section: Fertility |
(Were/Was) there any period(s) of more than three consecutive months when [Name of biological child(10)] did not live with you before that time?
| | 1 Yes |
| | 0 No |
| | 2 CHILD IS LESS THAN THREE MONTHS OLD |
| Q12-74.1 [Y01976.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS FIRST BORN.)
| Default Next: | Q12-76A.1 |
| Lead-In: | Q12-30C.10 [99:99], Q12-44.10 [5:5], Q12-44.10 [8:8], Q12-45.10 [1:1], Q12-51.10 [0:0], Q12-30.2 [Default], Q12-30.3 [Default], Q12-30.4 [Default], Q12-30.5 [Default], Q12-30.6 [Default], Q12-30.7 [Default], Q12-30.8 [Default], Q12-30.9 [Default], Q12-30.10 [Default], Q12-48.10 [Default], Q12-52.10 [Default], Q12-56.10 [Default], Q12-58.10 [Default] |
| Q12-76A.1 [Y01977.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.1
| Q12-77F.1 [Y01978.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 1]? What month and year?
| Q12-78F.1 [Y01979.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 1], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.1 [Y01980.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.1 [Y01981.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.1 [Y01982.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.1 [Y01983.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby? (IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.1 [Y01984.00] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 1]'s mother became pregnant with [Name of child from pregnancy 1], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.1 [Y01985.00] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 1]'s mother became pregnant?
| Q12-80M.1 [Y01986.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 1]'s mother to become pregnant?
| Q12-81M.1 [Y01987.00] | Section: Fertility |
Just before [Name of child from pregnancy 1]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.1 [Y01988.00] | Section: Fertility |
And what about [Name of child from pregnancy 1]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE: ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.1 [Y01989.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.1 [Y01990.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 1], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.1 [Y01991.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.1 [Y01992.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 1] was born?
| Q12-86.1 [Y01993.00] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.1 [Y01994.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 1] was born?
| Q12-88.1 [Y01995.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.1 [Y01996.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 1] was born?
| Q12-90.1 [Y01997.00] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.1 [Y01998.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 1] was born?
| Q12-92.1 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.1 [Y01999.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.1 [Y02000.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.1 [Y02001.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.1 [Y02002.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.1 [Y02003.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.1 [Y02004.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.1 [Y02005.00] | Section: Fertility |
([Q12-93.1]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.1 [Y02006.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.1 [Y02007.00] | Section: Fertility |
([Q12-94.1]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.1 [Y02008.00] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.1 [Y02009.00] | Section: Fertility |
([Q12-95.1]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.1 [Y02010.00] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.1 [Y02011.00] | Section: Fertility |
([Q12-96.1]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.1 [Y02012.00] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.1 [Y02013.00] | Section: Fertility |
([Q12-97.1]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.1 [Y02014.00] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.1 [Y02015.00] | Section: Fertility |
([Q12-98.1]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.1 [Y02016.00] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.1 [Y02017.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 1] born within one week of the expected (due) date?
| Q12-106A.1 [Y02018.00] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.1 [Y02019.00] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.1 [Y02020.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.1 [Y02021.00] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.1 [Y02022.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.1 [Y02023.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 1]?
| Q12-111.1 [Y02024.00] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 1)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 1)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.1) |
| Q12-112.1 [Y02025.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 1)]] - [[Respondent's weight before becoming pregnant (pregnancy 1)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.1
| Q12-113.1 [Y02026.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 1)]] < [[Respondent's weight before becoming pregnant (pregnancy 1)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.1 [Y02027.00] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 1] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.1 ([Respondent's weight before delivering (pregnancy 1)]) AND Q12-110.1 ([Respondent's weight before becoming pregnant (pregnancy 1)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.1 [Y02028.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 1] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.1 ([Respondent's weight before delivering (pregnancy 1)]) AND Q12-110.1 ([Respondent's weight before becoming pregnant (pregnancy 1)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.1 [Y02029.00] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.1 ([Respondent's weight before delivering (pregnancy 1)]) AND Q12-110.1 ([Respondent's weight before becoming pregnant (pregnancy 1)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.1 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 1]?
| Q12-117A.1 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.1 [Y02030.00] | Section: Fertility |
How much did [Name of child from pregnancy 1] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.1
| Q12-118B.1 [Y02031.00] | Section: Fertility |
(How much did [Name of child from pregnancy 1] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.1
| Q12-118C.1 [Y02032.00] | Section: Fertility |
Did [Name of child from pregnancy 1] weigh more than 5 1/2 pounds or less?
| Q12-119.1 [Y02033.00] | Section: Fertility |
What was [Name of child from pregnancy 1]'s length at birth?
| Q12-119A.1 [Y02034.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.1 [Y02035.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.1) |
| Q12-120A.1 [Y02036.00] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.1
| Q12-121.1 [Y02037.00] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.1 [Y02038.00] | Section: Fertility |
How many days earlier?
| Q12-122B.1 [] | Section: Fertility |
How many days later?
| Q12-123.1 [Y02039.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.1 [] | Section: Fertility |
When you took [Name of child from pregnancy 1] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.1 [Y02041.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.1 [Y02042.07] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 1].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.1.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.1 [Y02059.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 1] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 1]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.1 [Y02060.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 1]?
If Answer = 1 Then Go To Q12-129.1
| Q12-128.1 [Y02061.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 1]?
| Q12-129.1 [Y02062.08] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 1]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 1], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.1 [Y02073.00] | Section: Fertility |
([[Codes for places took child for main illness in first year
(pregnancy 1)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.1 [Y02074.00] | Section: Fertility |
When [Name of child from pregnancy 1] was admitted to the hospital, was surgery necessary?
| Q12-132.1 [Y02075.00] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.1 [Y02076.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.1 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.1 [Y02078.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.1 [Y02079.13] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 1].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-134.1.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.1 [Y02096.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 1] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 1]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.1 [Y02097.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 1]?
If Answer = 1 Then Go To Q12-139.1
| Q12-138.1 [Y02098.00] | Section: Fertility |
In [Name of child from pregnancy 1]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 1]?
| Q12-139.1 [Y02099.05] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 1]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 1], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.1 [] | Section: Fertility |
([[Codes for places took child for other illness in first year
(pregnancy 1)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.1 [] | Section: Fertility |
When [Name of child from pregnancy 1] was admitted to the hospital, was surgery necessary?
| Q12-142.1 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.1 [Y02110.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 1]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.1 [Y02111.10] | Section: Fertility |
How many months old was [Name of child from pregnancy 1] when you took (him/her) to a clinic or doctor for well baby care the first time?..... How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.1 [Y02125.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(1)]] = 1)
COMMENT: Was first child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.1 [Y02126.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.1 [Y02127.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(2)]] = 2)
COMMENT: Was first child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.1 [Y02128.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.1 [Y02129.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(3)]] = 3)
COMMENT: Was first child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.1 [Y02130.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.1 [Y02131.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(4)]] = 4)
COMMENT: Was first child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.1 [Y02132.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.1 [Y02133.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(5)]] = 5)
COMMENT: Was first child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.1 [Y02134.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.1 [Y02135.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(6)]] = 6)
COMMENT: Was first child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.1 [Y02136.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.1 [Y02137.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(7)]] = 7)
COMMENT: Was first child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.1 [Y02138.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.1 [Y02139.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(8)]] = 8)
COMMENT: Was first child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.1 [Y02140.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.1 [Y02141.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(9)]] = 9)
COMMENT: Was first child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.1 [Y02142.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.1 [Y02143.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(10)]] = 10)
COMMENT: Was first child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.1 [Y02144.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.1 [Y02145.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(11)]] = 11)
COMMENT: Was first child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.1 [Y02146.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.1 [Y02147.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 1)(12)]] = 12)
COMMENT: Was first child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.1 [Y02148.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 1] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.1 [Y02149.00] | Section: Fertility |
([Q12-30d.1] = 5) | ([Q12-30d.1] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.1 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 1]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.1 [Y02150.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.1 [Y02151.00] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 1]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.1 [Y02152.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 1]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.1 [Y02153.00] | Section: Fertility |
CHECK ([Name of biological child(2)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.2 [Y02154.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS SECOND BORN.)
| Q12-76A.2 [Y02155.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.2
| Q12-77F.2 [Y02156.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 2]? What month and year?
| Q12-78F.2 [Y02157.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 2], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.2 [Y02158.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.2 [Y02159.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.2 [Y02160.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.2 [Y02161.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.2 [Y02162.00] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 2]'s mother became pregnant with [Name of child from pregnancy 2], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.2 [Y02163.00] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 2]'s mother became pregnant?
| Q12-80M.2 [Y02164.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 2]'s mother to become pregnant?
| Q12-81M.2 [Y02165.00] | Section: Fertility |
Just before [Name of child from pregnancy 2]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.2 [Y02166.00] | Section: Fertility |
And what about [Name of child from pregnancy 2]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.2 [Y02167.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.2 [Y02168.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 2], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.2 [Y02169.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.2 [Y02170.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 2] was born?
| Q12-86.2 [Y02171.00] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.2 [Y02172.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 2] was born?
| Q12-88.2 [Y02173.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.2 [Y02174.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 2] was born?
| Q12-90.2 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.2 [Y02175.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 2] was born?
| Q12-92.2 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.2 [Y02176.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.2 [Y02177.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.2 [Y02178.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.2 [Y02179.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.2 [Y02180.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.2 [Y02181.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.2 [Y02182.00] | Section: Fertility |
([Q12-93.2]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.2 [Y02183.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.2 [Y02184.00] | Section: Fertility |
([Q12-94.2]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.2 [Y02185.00] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.2 [Y02186.00] | Section: Fertility |
([Q12-95.2]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.2 [Y02187.00] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.2 [Y02188.00] | Section: Fertility |
([Q12-96.2]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.2 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.2 [Y02189.00] | Section: Fertility |
([Q12-97.2]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.2 [Y02190.00] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.2 [Y02191.00] | Section: Fertility |
([Q12-98.2]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.2 [Y02192.00] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.2 [Y02193.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 2] born within one week of the expected (due) date?
| Q12-106A.2 [Y02194.00] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.2 [Y02195.00] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.2 [Y02196.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.2 [Y02197.00] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.2 [Y02198.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.2 [Y02199.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 2]?
| Q12-111.2 [Y02200.00] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 2)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 2)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.2) |
| Q12-112.2 [Y02201.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 2)]] - [[Respondent's weight before becoming pregnant (pregnancy 2)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.2
| Q12-113.2 [Y02202.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 2)]] < [[Respondent's weight before becoming pregnant (pregnancy 2)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.2 [Y02203.00] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 2] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.2 ([Respondent's weight before delivering (pregnancy 2)]) AND Q12-110.2 ([Respondent's weight before becoming pregnant (pregnancy 2)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.2 [Y02204.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 2] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.2 ([Respondent's weight before delivering (pregnancy 2)]) AND Q12-110.2 ([Respondent's weight before becoming pregnant (pregnancy 2)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.2 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.2 ([Respondent's weight before delivering (pregnancy 2)]) AND Q12-110.2 ([Respondent's weight before becoming pregnant (pregnancy 2)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.2 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 2]?
| Q12-117A.2 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.2 [Y02205.00] | Section: Fertility |
How much did [Name of child from pregnancy 2] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.2
| Q12-118B.2 [Y02206.00] | Section: Fertility |
(How much did [Name of child from pregnancy 2] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.2
| Q12-118C.2 [] | Section: Fertility |
Did [Name of child from pregnancy 2] weigh more than 5 1/2 pounds or less?
| Q12-119.2 [Y02207.00] | Section: Fertility |
What was [Name of child from pregnancy 2]'s length at birth?
| Q12-119A.2 [Y02208.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.2 [Y02209.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.2) |
| Q12-120A.2 [Y02210.00] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.2
| Q12-121.2 [Y02211.00] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.2 [Y02212.00] | Section: Fertility |
How many days earlier?
| Q12-122B.2 [] | Section: Fertility |
How many days later?
| Q12-123.2 [Y02213.00] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.2 [] | Section: Fertility |
When you took [Name of child from pregnancy 2] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.2 [Y02215.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.2 [Y02216.08] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptom or conditions occurred with (the/a) [first illness of child from pregnancy 2].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-124.2.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.2 [Y02233.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 2] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 2]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.2 [Y02234.00] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 2]?
If Answer = 1 Then Go To Q12-129.2
| Q12-128.2 [Y02235.00] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 2]?
| Q12-129.2 [Y02236.08] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 2]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 2], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.2 [] | Section: Fertility |
([[Codes for places took child for main illness in first year
(pregnancy 2)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.2 [] | Section: Fertility |
When [Name of child from pregnancy 2] was admitted to the hospital, was surgery necessary?
| Q12-132.2 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.2 [Y02247.00] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.2 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.2 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.2 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 2].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.2.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.2 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 2] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 2]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.2 [] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 2]?
If Answer = 1 Then Go To Q12-139.2
| Q12-138.2 [] | Section: Fertility |
In [Name of child from pregnancy 2]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 2]?
| Q12-139.2 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 2]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 2], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.2 [] | Section: Fertility |
([[Codes for places took child for other illness in first year
(pregnancy 2)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.2 [] | Section: Fertility |
When [Name of child from pregnancy 2] was admitted to the hospital, was surgery necessary?
| Q12-142.2 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.2 [Y02249.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 2]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.2 [Y02250.03] | Section: Fertility |
How many months old was [Name of child from pregnancy 2] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.2 [Y02264.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(1)]] = 1)
COMMENT: Was 2nd child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.2 [Y02265.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.2 [Y02266.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(2)]] = 2)
COMMENT: Was 2nd child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.2 [Y02267.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.2 [Y02268.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(3)]] = 3)
COMMENT: Was 2nd child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.2 [Y02269.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.2 [Y02270.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(4)]] = 4)
COMMENT: Was 2nd child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.2 [Y02271.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.2 [Y02272.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(5)]] = 5)
COMMENT: Was 2nd child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.2 [Y02273.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.2 [Y02274.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(6)]] = 6)
COMMENT: Was 2nd child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.2 [Y02275.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.2 [Y02276.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(7)]] = 7)
COMMENT: Was 2nd child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.2 [Y02277.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.2 [Y02278.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(8)]] = 8)
COMMENT: Was 2nd child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.2 [Y02279.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.2 [Y02280.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(9)]] = 9)
COMMENT: Was 2nd child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.2 [Y02281.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.2 [Y02282.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(10)]] = 10)
COMMENT: Was 2nd child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.2 [Y02283.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.2 [Y02284.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(11)]] = 11)
COMMENT: Was 2nd child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.2 [Y02285.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.2 [Y02286.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 2)(12)]] = 12)
COMMENT: Was 2nd child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.2 [Y02287.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 2] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.2 [Y02288.00] | Section: Fertility |
([Q12-30d.2] = 5) | ([Q12-30d.2] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.2 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 2]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.2 [Y02289.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.2 [Y02290.00] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 2]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.2 [Y02291.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 2]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.2 [Y02292.00] | Section: Fertility |
CHECK ([Name of biological child(3)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.3 [Y02293.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS THIRD BORN.)
| Q12-76A.3 [Y02294.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.3
| Q12-77F.3 [Y02295.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 3]? What month and year?
| Q12-78F.3 [Y02296.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 3], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.3 [Y02297.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.3 [Y02298.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.3 [Y02299.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.3 [Y02300.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have
(none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.3 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 3]'s mother became pregnant with [Name of child from pregnancy 3], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.3 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 3]'s mother became pregnant?
| Q12-80M.3 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 3]'s mother to become pregnant?
| Q12-81M.3 [] | Section: Fertility |
Just before [Name of child from pregnancy 3]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.3 [] | Section: Fertility |
And what about [Name of child from pregnancy 3]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.3 [Y02301.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.3 [Y02302.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 3], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.3 [Y02303.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.3 [Y02304.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 3] was born?
| Q12-86.3 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.3 [Y02305.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 3] was born?
| Q12-88.3 [Y02306.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.3 [Y02307.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 3] was born?
| Q12-90.3 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.3 [Y02308.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 3] was born?
| Q12-92.3 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.3 [Y02309.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.3 [Y02310.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.3 [Y02311.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.3 [Y02312.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.3 [Y02313.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.3 [Y02314.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.3 [Y02315.00] | Section: Fertility |
([Q12-93.3]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.3 [Y02316.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.3 [Y02317.00] | Section: Fertility |
([Q12-94.3]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.3 [Y02318.00] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.3 [Y02319.00] | Section: Fertility |
([Q12-95.3]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.3 [Y02320.00] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.3 [Y02321.00] | Section: Fertility |
([Q12-96.3]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.3 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.3 [Y02322.00] | Section: Fertility |
([Q12-97.3]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.3 [Y02323.00] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.3 [Y02324.00] | Section: Fertility |
([Q12-98.3]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.3 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.3 [Y02325.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 3] born within one week of the expected (due) date?
| Q12-106A.3 [Y02326.00] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.3 [Y02327.00] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.3 [Y02328.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.3 [Y02329.00] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.3 [Y02330.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.3 [Y02331.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 3]?
| Q12-111.3 [Y02332.00] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 3)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 3)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.3) |
| Q12-112.3 [Y02333.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 3)]] - [[Respondent's weight before becoming pregnant (pregnancy 3)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.3
| Q12-113.3 [Y02334.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 3)]] < [[Respondent's weight before becoming pregnant (pregnancy 3)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.3 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 3] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.3 ([Respondent's weight before delivering (pregnancy 3)]) AND Q12-110.3 ([Respondent's weight before becoming pregnant (pregnancy 3)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.3 [Y02335.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 3] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.3 ([Respondent's weight before delivering (pregnancy 3)]) AND Q12-110.3 ([Respondent's weight before becoming pregnant (pregnancy 3)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.3 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.3 ([Respondent's weight before delivering (pregnancy 3)]) AND Q12-110.3 ([Respondent's weight before becoming pregnant (pregnancy 3)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.3 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 3]?
| Q12-117A.3 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.3 [Y02336.00] | Section: Fertility |
How much did [Name of child from pregnancy 3] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.3
| Q12-118B.3 [Y02337.00] | Section: Fertility |
(How much did [Name of child from pregnancy 3] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
If Answer >= -2 AND Answer <= -1 Then Go To Q12-118C.3
| Q12-118C.3 [Y02338.00] | Section: Fertility |
Did [Name of child from pregnancy 3] weigh more than 5 1/2 pounds or less?
| Q12-119.3 [Y02339.00] | Section: Fertility |
What was [Name of child from pregnancy 3]'s length at birth?
| Q12-119A.3 [Y02340.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.3 [Y02341.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.3) |
| Q12-120A.3 [Y02342.00] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.3
| Q12-121.3 [Y02343.00] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.3 [Y02344.00] | Section: Fertility |
How many days earlier?
| Q12-122B.3 [] | Section: Fertility |
How many days later?
| Q12-123.3 [Y02345.00] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.3 [] | Section: Fertility |
When you took [Name of child from pregnancy 3] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.3 [Y02347.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.3 [Y02348.07] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 3].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.3.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.3 [Y02365.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 3] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 3]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.3 [Y02366.00] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 3]?
If Answer = 1 Then Go To Q12-129.3
| Q12-128.3 [Y02367.00] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 3]?
| Q12-129.3 [Y02368.08] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 3]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 3], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.3 [] | Section: Fertility |
([[Codes for places took child for main illness in first year
(pregnancy 3)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.3 [Y02380.00] | Section: Fertility |
When [Name of child from pregnancy 3] was admitted to the hospital, was surgery necessary?
| Q12-132.3 [Y02381.00] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.3 [Y02382.00] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.3 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.3 [Y02384.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.3 [Y02385.07] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 3].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.3.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.3 [Y02402.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 3] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 3]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.3 [Y02403.00] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 3]?
If Answer = 1 Then Go To Q12-139.3
| Q12-138.3 [] | Section: Fertility |
In [Name of child from pregnancy 3]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 3]?
| Q12-139.3 [Y02404.06] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 3]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 3], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.3 [] | Section: Fertility |
([[Codes for places took child for other illness in first year
(pregnancy 3)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.3 [Y02416.00] | Section: Fertility |
When [Name of child from pregnancy 3] was admitted to the hospital, was surgery necessary?
| Q12-142.3 [Y02417.00] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.3 [Y02418.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 3]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.3 [Y02419.10] | Section: Fertility |
How many months old was [Name of child from pregnancy 3] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.3 [Y02433.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(1)]] = 1)
COMMENT: Was 3rd child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.3 [Y02434.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.3 [Y02435.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(2)]] = 2)
COMMENT: Was 3rd child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.3 [Y02436.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.3 [Y02437.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(3)]] = 3)
COMMENT: Was 3rd child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.3 [Y02438.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.3 [Y02439.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(4)]] = 4)
COMMENT: Was 3rd child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.3 [Y02440.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.3 [Y02441.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(5)]] = 5)
COMMENT: Was 3rd child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.3 [Y02442.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.3 [Y02443.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(6)]] = 6)
COMMENT: Was 3rd child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.3 [Y02444.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.3 [Y02445.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(7)]] = 7)
COMMENT: Was 3rd child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.3 [Y02446.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.3 [Y02447.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(8)]] = 8)
COMMENT: Was 3rd child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.3 [Y02448.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.3 [Y02449.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(9)]] = 9)
COMMENT: Was 3rd child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.3 [Y02450.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.3 [Y02451.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(10)]] = 10)
COMMENT: Was 3rd child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.3 [Y02452.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.3 [Y02453.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(11)]] = 11)
COMMENT: Was 3rd child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.3 [Y02454.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.3 [Y02455.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 3)(12)]] = 12)
COMMENT: Was 3rd child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.3 [Y02456.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 3] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.3 [Y02457.00] | Section: Fertility |
([Q12-30d.3] = 5) | ([Q12-30d.3] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.3 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 3]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.3 [Y02458.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.3 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 3]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.3 [Y02459.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 3]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.3 [Y02460.00] | Section: Fertility |
CHECK ([Name of biological child(4)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.4 [Y02461.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS FOURTH BORN.)
| Q12-76A.4 [Y02462.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.4
| Q12-77F.4 [Y02463.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 4]? What month and year?
| Q12-78F.4 [Y02464.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 4], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.4 [Y02465.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.4 [Y02466.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.4 [Y02467.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.4 [Y02468.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby? (IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.4 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 4]'s mother became pregnant with [Name of child from pregnancy 4], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.4 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 4]'s mother became pregnant?
| Q12-80M.4 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 4]'s mother to become pregnant?
| Q12-81M.4 [] | Section: Fertility |
Just before [Name of child from pregnancy 4]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.4 [] | Section: Fertility |
And what about [Name of child from pregnancy 4]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.4 [Y02469.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.4 [Y02470.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 4], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.4 [Y02471.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.4 [Y02472.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 4] was born?
| Q12-86.4 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.4 [Y02473.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 4] was born?
| Q12-88.4 [Y02474.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.4 [Y02475.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 4] was born?
| Q12-90.4 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.4 [Y02476.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 4] was born?
| Q12-92.4 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.4 [Y02477.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.4 [Y02478.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.4 [Y02479.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.4 [Y02480.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.4 [Y02481.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.4 [Y02482.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.4 [Y02483.00] | Section: Fertility |
([Q12-93.4]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.4 [Y02484.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.4 [Y02485.00] | Section: Fertility |
([Q12-94.4]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.4 [Y02486.00] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.4 [Y02487.00] | Section: Fertility |
([Q12-95.4]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.4 [Y02488.00] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.4 [Y02489.00] | Section: Fertility |
([Q12-96.4]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.4 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.4 [Y02490.00] | Section: Fertility |
([Q12-97.4]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.4 [Y02491.00] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.4 [Y02492.00] | Section: Fertility |
([Q12-98.4]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.4 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.4 [Y02493.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 4] born within one week of the expected (due) date?
| Q12-106A.4 [Y02494.00] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.4 [Y02495.00] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.4 [Y02496.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.4 [Y02497.00] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.4 [Y02498.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.4 [Y02499.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 4]?
| Q12-111.4 [Y02500.00] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 4)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 4)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.4) |
| Q12-112.4 [Y02501.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 4)]] - [[Respondent's weight before becoming pregnant (pregnancy 4)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.4
| Q12-113.4 [Y02502.00] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 4)]] < [[Respondent's weight before becoming pregnant (pregnancy 4)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.4 [Y02503.00] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 4] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.4 ([Respondent's weight before delivering (pregnancy 4)]) AND Q12-110.4 ([Respondent's weight before becoming pregnant (pregnancy 4)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.4 [Y02504.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 4] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.4 ([Respondent's weight before delivering (pregnancy 4)]) AND Q12-110.4 ([Respondent's weight before becoming pregnant (pregnancy 4)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.4 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.4 ([Respondent's weight before delivering (pregnancy 4)]) AND Q12-110.4 ([Respondent's weight before becoming pregnant (pregnancy 4)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.4 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 4]?
| Q12-117A.4 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.4 [Y02505.00] | Section: Fertility |
How much did [Name of child from pregnancy 4] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.4 [Y02506.00] | Section: Fertility |
(How much did [Name of child from pregnancy 4] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.4 [Y02507.00] | Section: Fertility |
What was [Name of child from pregnancy 4]'s length at birth?
| Q12-119A.4 [Y02508.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.4 [Y02509.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.4) |
| Q12-120A.4 [Y02510.00] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.4
| Q12-121.4 [Y02511.00] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.4 [] | Section: Fertility |
How many days earlier?
| Q12-122B.4 [] | Section: Fertility |
How many days later?
| Q12-123.4 [Y02512.00] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.4 [] | Section: Fertility |
When you took [Name of child from pregnancy 4] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.4 [Y02514.00] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.4 [Y02515.03] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 4].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-124.4.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.4 [Y02532.00] | Section: Fertility |
How many months old was [Name of child from pregnancy 4] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 4]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.4 [Y02533.00] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 4]?
If Answer = 1 Then Go To Q12-129.4
| Q12-128.4 [Y02534.00] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 4]?
| Q12-129.4 [Y02535.00] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 4]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 4], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.4 [] | Section: Fertility |
([[Codes for places took child for main illness in first year
(pregnancy 4)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.4 [] | Section: Fertility |
When [Name of child from pregnancy 4] was admitted to the hospital, was surgery necessary?
| Q12-132.4 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.4 [Y02546.00] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.4 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.4 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.4 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 4].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.4.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.4 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 4] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 4]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.4 [] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 4]?
If Answer = 1 Then Go To Q12-139.4
| Q12-138.4 [] | Section: Fertility |
In [Name of child from pregnancy 4]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 4]?
| Q12-139.4 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 4]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 4], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.4 [] | Section: Fertility |
([[Codes for places took child for other illness in first year
(pregnancy 4)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.4 [] | Section: Fertility |
When [Name of child from pregnancy 4] was admitted to the hospital, was surgery necessary?
| Q12-142.4 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.4 [Y02548.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 4]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.4 [Y02549.09] | Section: Fertility |
How many months old was [Name of child from pregnancy 4] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.4 [Y02563.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(1)]] = 1)
COMMENT: Was 4th child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.4 [Y02564.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.4 [Y02565.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(2)]] = 2)
COMMENT: Was 4th child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.4 [Y02566.00] | Section: Fertility |
(HAND CARD W) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.4 [Y02567.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(3)]] = 3)
COMMENT: Was 4th child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.4 [Y02568.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.4 [Y02569.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(4)]] = 4)
COMMENT: Was 4th child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.4 [Y02570.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.4 [Y02571.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(5)]] = 5)
COMMENT: Was 4th child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.4 [Y02572.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.4 [Y02573.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(6)]] = 6)
COMMENT: Was 4th child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.4 [Y02574.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.4 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(7)]] = 7)
COMMENT: Was 4th child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.4 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.4 [Y02575.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(8)]] = 8)
COMMENT: Was 4th child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.4 [Y02576.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.4 [Y02577.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(9)]] = 9)
COMMENT: Was 4th child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.4 [Y02578.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.4 [Y02579.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(10)]] = 10)
COMMENT: Was 4th child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.4 [Y02580.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.4 [Y02581.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(11)]] = 11)
COMMENT: Was 4th child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.4 [Y02582.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.4 [Y02583.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 4)(12)]] = 12)
COMMENT: Was 4th child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.4 [Y02584.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 4] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.4 [Y02585.00] | Section: Fertility |
([Q12-30d.4] = 5) | ([Q12-30d.4] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.4 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 4]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.4 [Y02586.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.4 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 4]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.4 [Y02587.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 4]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.4 [Y02588.00] | Section: Fertility |
CHECK ([Name of biological child(5)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.5 [Y02589.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS FIFTH BORN.)
| Q12-76A.5 [Y02590.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.5
| Q12-77F.5 [Y02591.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 5]? What month and year?
| Q12-78F.5 [Y02592.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 5], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.5 [Y02593.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.5 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.5 [Y02594.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.5 [Y02595.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have
(none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.5 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 5]'s mother became pregnant with [Name of child from pregnancy 5], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.5 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 5]'s mother became pregnant?
| Q12-80M.5 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 5]'s mother to become pregnant?
| Q12-81M.5 [] | Section: Fertility |
Just before [Name of child from pregnancy 5]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.5 [] | Section: Fertility |
And what about [Name of child from pregnancy 5]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.5 [Y02596.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.5 [Y02597.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 5], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.5 [Y02598.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.5 [Y02599.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 5] was born?
| Q12-86.5 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.5 [Y02600.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 5] was born?
| Q12-88.5 [Y02601.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.5 [Y02602.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 5] was born?
| Q12-90.5 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.5 [Y02603.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 5] was born?
| Q12-92.5 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.5 [Y02604.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.5 [Y02605.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.5 [Y02606.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.5 [Y02607.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.5 [Y02608.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.5 [Y02609.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.5 [Y02610.00] | Section: Fertility |
([Q12-93.5]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.5 [Y02611.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.5 [Y02612.00] | Section: Fertility |
([Q12-94.5]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.5 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.5 [Y02613.00] | Section: Fertility |
([Q12-95.5]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.5 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.5 [Y02614.00] | Section: Fertility |
([Q12-96.5]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.5 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.5 [Y02615.00] | Section: Fertility |
([Q12-97.5]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.5 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.5 [Y02616.00] | Section: Fertility |
([Q12-98.5]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.5 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.5 [Y02617.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 5] born within one week of the expected (due) date?
| Q12-106A.5 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.5 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.5 [Y02618.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.5 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.5 [Y02619.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.5 [Y02620.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 5]?
| Q12-111.5 [] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 5)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 5)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.5) |
| Q12-112.5 [] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 5)]] - [[Respondent's weight before becoming pregnant (pregnancy 5)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.5
| Q12-113.5 [] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 5)]] < [[Respondent's weight before becoming pregnant (pregnancy 5)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.5 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 5] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.5 ([Respondent's weight before delivering (pregnancy 5)]) AND Q12-110.5 ([Respondent's weight before becoming pregnant (pregnancy 5)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.5 [Y02624.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 5] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.5 ([Respondent's weight before delivering (pregnancy 5)]) AND Q12-110.5 ([Respondent's weight before becoming pregnant (pregnancy 5)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.5 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.5 ([Respondent's weight before delivering (pregnancy 5)]) AND Q12-110.5 ([Respondent's weight before becoming pregnant (pregnancy 5)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.5 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 5]?
| Q12-117A.5 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.5 [Y02625.00] | Section: Fertility |
How much did [Name of child from pregnancy 5] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.5 [Y02626.00] | Section: Fertility |
(How much did [Name of child from pregnancy 5] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.5 [Y02627.00] | Section: Fertility |
What was [Name of child from pregnancy 5]'s length at birth?
| Q12-119A.5 [Y02628.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.5 [Y02629.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.5) |
| Q12-120A.5 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.5
| Q12-121.5 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.5 [] | Section: Fertility |
How many days earlier?
| Q12-122B.5 [] | Section: Fertility |
How many days later?
| Q12-123.5 [Y02630.00] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.5 [] | Section: Fertility |
When you took [Name of child from pregnancy 5] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.5 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.5 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 5].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-124.5.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.5 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 5] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 5]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.5 [] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 5]?
If Answer = 1 Then Go To Q12-129.5
| Q12-128.5 [] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 5]?
| Q12-129.5 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 5]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 5], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.5 [] | Section: Fertility |
([[Codes for places took child for main illness in first year
(pregnancy 5)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.5 [] | Section: Fertility |
When [Name of child from pregnancy 5] was admitted to the hospital, was surgery necessary?
| Q12-132.5 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.5 [] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.5 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.5 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.5 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 5].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.5.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.5 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 5] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 5]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.5 [] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 5]?
If Answer = 1 Then Go To Q12-139.5
| Q12-138.5 [] | Section: Fertility |
In [Name of child from pregnancy 5]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 5]?
| Q12-139.5 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 5]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 5], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.5 [] | Section: Fertility |
([[Codes for places took child for other illness in first year
(pregnancy 5)(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.5 [] | Section: Fertility |
When [Name of child from pregnancy 5] was admitted to the hospital, was surgery necessary?
| Q12-142.5 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.5 [Y02633.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 5]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.5 [Y02634.11] | Section: Fertility |
How many months old was [Name of child from pregnancy 5] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(1)]] = 1)
COMMENT: Was 5th child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(2)]] = 2)
COMMENT: Was 5th child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.5 [Y02649.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(3)]] = 3)
COMMENT: Was 5th child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.5 [Y02650.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(4)]] = 4)
COMMENT: Was 5th child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.5 [Y02651.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(5)]] = 5)
COMMENT: Was 5th child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.5 [Y02652.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(6)]] = 6)
COMMENT: Was 5th child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.5 [Y02653.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(7)]] = 7)
COMMENT: Was 5th child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(8)]] = 8)
COMMENT: Was 5th child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.5 [Y02654.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(9)]] = 9)
COMMENT: Was 5th child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.5 [Y02655.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.5 [] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(10)]] = 10)
COMMENT: Was 5th child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.5 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.5 [Y02656.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(11)]] = 11)
COMMENT: Was 5th child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.5 [Y02657.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.5 [Y02658.00] | Section: Fertility |
([[Ages in months of baby when taken for first year well baby care (pregnancy 5)(12)]] = 12)
COMMENT: Was 5th child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.5 [Y02659.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 5] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.5 [Y02660.00] | Section: Fertility |
([Q12-30d.5] = 5) | ([Q12-30d.5] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.5 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 5]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.5 [Y02661.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.5 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 5]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.5 [Y02662.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 5]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.5 [Y02663.00] | Section: Fertility |
CHECK ([Name of biological child(6)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.6 [Y02664.00] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS SIXTH BORN.)
| Q12-76A.6 [Y02665.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.6
| Q12-77F.6 [Y02666.00] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 6]? What month and year?
| Q12-78F.6 [Y02667.00] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 6], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.6 [Y02668.00] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.6 [Y02669.00] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.6 [Y02670.00] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.6 [Y02671.00] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have
(none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.6 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 6]'s mother became pregnant with [Name of child from pregnancy 6], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.6 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 6]'s mother became pregnant?
| Q12-80M.6 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 6]'s mother to become pregnant?
| Q12-81M.6 [] | Section: Fertility |
Just before [Name of child from pregnancy 6]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.6 [] | Section: Fertility |
And what about [Name of child from pregnancy 6]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.6 [Y02672.00] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.6 [Y02673.00] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 6], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.6 [Y02674.00] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.6 [Y02675.00] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 6] was born?
| Q12-86.6 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.6 [Y02676.00] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 6] was born?
| Q12-88.6 [Y02677.00] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.6 [Y02678.00] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 6] was born?
| Q12-90.6 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.6 [Y02679.00] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 6] was born?
| Q12-92.6 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.6 [Y02680.00] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.6 [Y02681.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.6 [Y02682.00] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.6 [Y02683.00] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.6 [Y02684.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.6 [Y02685.00] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.6 [Y02686.00] | Section: Fertility |
([Q12-93.6]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.6 [Y02687.00] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.6 [Y02688.00] | Section: Fertility |
([Q12-94.6]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.6 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.6 [Y02689.00] | Section: Fertility |
([Q12-95.6]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.6 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.6 [Y02690.00] | Section: Fertility |
([Q12-96.6]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.6 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.6 [Y02691.00] | Section: Fertility |
([Q12-97.6]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.6 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.6 [Y02692.00] | Section: Fertility |
([Q12-98.6]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.6 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.6 [Y02693.00] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 6] born within one week of the expected (due) date?
| Q12-106A.6 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.6 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.6 [Y02694.00] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.6 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.6 [Y02695.00] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.6 [Y02696.00] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 6]?
| Q12-111.6 [] | Section: Fertility |
(([[Respondent's weight before delivering (pregnancy 6)]] >= 0) & ([[Respondent's weight before becoming pregnant (pregnancy 6)]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.6) |
| Q12-112.6 [] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 6)]] - [[Respondent's weight before becoming pregnant (pregnancy 6)]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.6
| Q12-113.6 [] | Section: Fertility |
([[Respondent's weight before delivering (pregnancy 6)]] < [[Respondent's weight before becoming pregnant (pregnancy 6)]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.6 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 6] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.6 ([Respondent's weight before delivering (pregnancy 6)]) AND Q12-110.6 ([Respondent's weight before becoming pregnant (pregnancy 6)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.6 [Y02700.00] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 6] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.6 ([Respondent's weight before delivering (pregnancy 6)]) AND Q12-110.6 ([Respondent's weight before becoming pregnant (pregnancy 6)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.6 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.6 ([Respondent's weight before delivering (pregnancy 6)]) AND Q12-110.6 ([Respondent's weight before becoming pregnant (pregnancy 6)]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.6 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 6]?
| Q12-117A.6 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.6 [Y02701.00] | Section: Fertility |
How much did [Name of child from pregnancy 6] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.6 [Y02702.00] | Section: Fertility |
(How much did [Name of child from pregnancy 6] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.6 [Y02703.00] | Section: Fertility |
What was [Name of child from pregnancy 6]'s length at birth?
| Q12-119A.6 [Y02704.00] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.6 [Y02705.00] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.6) |
| Q12-120A.6 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.6
| Q12-121.6 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.6 [] | Section: Fertility |
How many days earlier?
| Q12-122B.6 [] | Section: Fertility |
How many days later?
| Q12-123.6 [Y02706.00] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.6 [] | Section: Fertility |
When you took [Name of child from pregnancy 6] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.6 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.6 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 6].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.6.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.6 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 6] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 6]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.6 [] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 6]?
If Answer = 1 Then Go To Q12-129.6
| Q12-128.6 [] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 6]?
| Q12-129.6 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 6]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 6], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.6 [] | Section: Fertility |
([[Q12-129.6-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.6 [] | Section: Fertility |
When [Name of child from pregnancy 6] was admitted to the hospital, was surgery necessary?
| Q12-132.6 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.6 [] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.6 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.6 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.6 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 6].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.6.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.6 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 6] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 6]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.6 [] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 6]?
If Answer = 1 Then Go To Q12-139.6
| Q12-138.6 [] | Section: Fertility |
In [Name of child from pregnancy 6]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 6]?
| Q12-139.6 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 6]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 6], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.6 [] | Section: Fertility |
([[Q12-139.6-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.6 [] | Section: Fertility |
When [Name of child from pregnancy 6] was admitted to the hospital, was surgery necessary?
| Q12-142.6 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.6 [Y02709.00] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 6]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.6 [Y02710.10] | Section: Fertility |
How many months old was [Name of child from pregnancy 6] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(1)]] = 1)
COMMENT: Was 6th child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.6 [Y02725.00] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(2)]] = 2)
COMMENT: Was 6th child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(3)]] = 3)
COMMENT: Was 6th child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(4)]] = 4)
COMMENT: Was 6th child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(5)]] = 5)
COMMENT: Was 6th child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(6)]] = 6)
COMMENT: Was 6th child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(7)]] = 7)
COMMENT: Was 6th child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(8)]] = 8)
COMMENT: Was 6th child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(9)]] = 9)
COMMENT: Was 6th child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(10)]] = 10)
COMMENT: Was 6th child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(11)]] = 11)
COMMENT: Was 6th child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.6 [] | Section: Fertility |
([[Q12-144.6-CODEALL(12)]] = 12)
COMMENT: Was 6th child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.6 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 6] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.6 [Y02726.00] | Section: Fertility |
([Q12-30d.6] = 5) | ([Q12-30d.6] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.6 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 6]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.6 [Y02727.00] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.6 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 6]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.6 [Y02728.00] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. s [Name of child from pregnancy 6]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.6 [Y02729.00] | Section: Fertility |
CHECK ([Name of biological child(7)])
COMMENT: check if to loop again 2nd time
| | 1 CONDITION APPLIES ...(Go To Q12-74.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-74.7 [] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS SEVENTH BORN.)
| Q12-76A.7 [] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.7
| Q12-77F.7 [] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]? What month and year?
| Q12-78F.7 [] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.7 [] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.7 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.7 [] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.7 [] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.7 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s mother became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.7 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s mother became pregnant?
| Q12-80M.7 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s mother to become pregnant?
| Q12-81M.7 [] | Section: Fertility |
Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s mother became pregnant that time, did you want her to become pegnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.7 [] | Section: Fertility |
And what about [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.7 [] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.7 [] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.7 [] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.7 [] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was born?
| Q12-86.7 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.7 [] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was born?
| Q12-88.7 [] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.7 [] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was born?
| Q12-90.7 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.7 [] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was born?
| Q12-92.7 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.7 [] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.7 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.7 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.7 [] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.7 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.7 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.7 [] | Section: Fertility |
([Q12-93.7]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.7 [] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.7 [] | Section: Fertility |
([Q12-94.7]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.7 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.7 [] | Section: Fertility |
([Q12-95.7]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.7 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.7 [] | Section: Fertility |
([Q12-96.7]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.7 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.7 [] | Section: Fertility |
([Q12-97.7]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.7 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.7 [] | Section: Fertility |
([Q12-98.7]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.7 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.7 [] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] born within one week of the expected (due) date?
| Q12-106A.7 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.7 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.7 [] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.7 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.7 [] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.7 [] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]?
| Q12-111.7 [] | Section: Fertility |
(([[Q12-109.7]] >= 0) & ([[Q12-110.7]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.7) |
| Q12-112.7 [] | Section: Fertility |
([[Q12-109.7]] - [[Q12-110.7]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.7
| Q12-113.7 [] | Section: Fertility |
([[Q12-109.7]] < [[Q12-110.7]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.7 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain loss during pregnancy (pregnancy 7)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.7 ([Q12-109.7]) AND Q12-110.7 ([Q12-110.7]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.7 [] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain loss during pregnancy (pregnancy 7)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.7 ([Q12-109.7]) AND Q12-110.7 ([Q12-110.7]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.7 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.7 ([Q12-109.7]) AND Q12-110.7 ([Q12-110.7]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.7 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]?
| Q12-117A.7 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.7 [] | Section: Fertility |
How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.7 [] | Section: Fertility |
(How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.7 [] | Section: Fertility |
What was [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s length at birth?
| Q12-119A.7 [] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.7 [] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.7) |
| Q12-120A.7 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.7
| Q12-121.7 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.7 [] | Section: Fertility |
How many days earlier?
| Q12-122B.7 [] | Section: Fertility |
How many days later?
| Q12-123.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.7 [] | Section: Fertility |
When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.7 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.7 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 7)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-124.7.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.7 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 7)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 7)]?
If Answer = 1 Then Go To Q12-129.7
| Q12-128.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 7)]?
| Q12-129.7 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 7)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.7 [] | Section: Fertility |
([[Q12-129.7-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.7 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was admitted to the hospital, was surgery necessary?
| Q12-132.7 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.7 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.7 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.7 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 7)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-134.7.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.7 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 7)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 7)]?
If Answer = 1 Then Go To Q12-139.7
| Q12-138.7 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 7)]?
| Q12-139.7 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 7)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.7 [] | Section: Fertility |
([[Q12-139.7-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.7 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] was admitted to the hospital, was surgery necessary?
| Q12-142.7 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.7 [] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.7 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(1)]] = 1)
COMMENT: Was first child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(2)]] = 2)
COMMENT: Was first child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(3)]] = 3)
COMMENT: Was first child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(4)]] = 4)
COMMENT: Was first child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(5)]] = 5)
COMMENT: Was first child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(6)]] = 6)
COMMENT: Was first child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(7)]] = 7)
COMMENT: Was first child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(8)]] = 8)
COMMENT: Was first child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(9)]] = 9)
COMMENT: Was first child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(10)]] = 10)
COMMENT: Was first child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(11)]] = 11)
COMMENT: Was first child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.7 [] | Section: Fertility |
([[Q12-144.7-CODEALL(12)]] = 12)
COMMENT: Was first child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.7 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.7 [] | Section: Fertility |
([Q12-30d.7] = 5) | ([Q12-30d.7] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.7 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.7 [] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.7 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.7 [] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy since last expanded fertility interview (pregnancy 7)]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.7 [] | Section: Fertility |
CHECK ([Name of biological child(8)])
COMMENT: check if to loop again 2nd time
If Answer = 1 Then Go To Q12-74.8
| Q12-74.8 [] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS EIGHTH BORN.)
| Q12-76A.8 [] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.8
| Q12-77F.8 [] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]? What month and year?
| Q12-78F.8 [] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.8 [] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.8 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.8 [] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.8 [] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have
(none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.8 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s mother became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.8 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s mother became pregnant?
| Q12-80M.8 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s mother to become pregnant?
| Q12-81M.8 [] | Section: Fertility |
Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.8 [] | Section: Fertility |
And what about [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.8 [] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.8 [] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.8 [] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.8 [] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was born?
| Q12-86.8 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.8 [] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was born?
| Q12-88.8 [] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.8 [] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was born?
| Q12-90.8 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.8 [] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was born?
| Q12-92.8 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.8 [] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.8 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.8 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.8 [] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.8 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.8 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.8 [] | Section: Fertility |
([Q12-93.8]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.8 [] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.8 [] | Section: Fertility |
([Q12-94.8]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.8 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.8 [] | Section: Fertility |
([Q12-95.8]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.8 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.8 [] | Section: Fertility |
([Q12-96.8]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.8 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.8 [] | Section: Fertility |
([Q12-97.8]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.8 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.8 [] | Section: Fertility |
([Q12-98.8]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.8 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.8 [] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] born within one week of the expected (due) date?
| Q12-106A.8 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.8 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.8 [] | Section: Fertility |
Was a cesarean section done? (IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.8 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.8 [] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.8 [] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]?
| Q12-111.8 [] | Section: Fertility |
(([[Q12-109.8]] >= 0) & ([[Q12-110.8]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.8) |
| Q12-112.8 [] | Section: Fertility |
([[Q12-109.8]] - [[Q12-110.8]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.8
| Q12-113.8 [] | Section: Fertility |
([[Q12-109.8]] < [[Q12-110.8]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.8 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain loss during pregnancy (pregnancy 8)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.8 ([Q12-109.8]) AND Q12-110.8 ([Q12-110.8]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.8 [] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain loss during pregnancy (pregnancy 8)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.8 ([Q12-109.8]) AND Q12-110.8 ([Q12-110.8]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.8 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.8 ([Q12-109.8]) AND Q12-110.8 ([Q12-110.8]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.8 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]?
| Q12-117A.8 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.8 [] | Section: Fertility |
How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.8 [] | Section: Fertility |
(How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.8 [] | Section: Fertility |
What was [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s length at birth?
| Q12-119A.8 [] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.8 [] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.8) |
| Q12-120A.8 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.8
| Q12-121.8 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.8 [] | Section: Fertility |
How many days earlier?
| Q12-122B.8 [] | Section: Fertility |
How many days later?
| Q12-123.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.8 [] | Section: Fertility |
When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.8 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.8 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 8)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.8.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.8 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 8)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 8)]?
If Answer = 1 Then Go To Q12-129.8
| Q12-128.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 8)]?
| Q12-129.8 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 8)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.8 [] | Section: Fertility |
([[Q12-129.8-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.8 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was admitted to the hospital, was surgery necessary?
| Q12-132.8 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.8 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.8 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.8 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 8)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY RECORDED IN 12-134.8.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.8 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 8)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 8)]?
If Answer = 1 Then Go To Q12-139.8
| Q12-138.8 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 8)]?
| Q12-139.8 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 8)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.8 [] | Section: Fertility |
([[Q12-139.8-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.8 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] was admitted to the hospital, was surgery necessary?
| Q12-142.8 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.8 [] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.8 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(1)]] = 1)
COMMENT: Was first child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(2)]] = 2)
COMMENT: Was first child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(3)]] = 3)
COMMENT: Was first child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(4)]] = 4)
COMMENT: Was first child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(5)]] = 5)
COMMENT: Was first child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(6)]] = 6)
COMMENT: Was first child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(7)]] = 7)
COMMENT: Was first child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(8)]] = 8)
COMMENT: Was first child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(9)]] = 9)
COMMENT: Was first child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(10)]] = 10)
COMMENT: Was first child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(11)]] = 11)
COMMENT: Was first child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.8 [] | Section: Fertility |
([[Q12-144.8-CODEALL(12)]] = 12)
COMMENT: Was first child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.8 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.8 [] | Section: Fertility |
([Q12-30d.8] = 5) | ([Q12-30d.8] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.8 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.8 [] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.8 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.8 [] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy since last expanded fertility interview (pregnancy 8)]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.8 [] | Section: Fertility |
CHECK ([Name of biological child(9)])
COMMENT: check if to loop again 2nd time
If Answer = 1 Then Go To Q12-74.9
| Q12-74.9 [] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS NINTH BORN.)
| Q12-76A.9 [] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.9
| Q12-77F.9 [] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]? What month and year?
| Q12-78F.9 [] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.9 [] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.9 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.9 [] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.9 [] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby? (IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.9 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s mother became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.9 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s mother became pregnant?
| Q12-80M.9 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s mother to become pregnant?
| Q12-81M.9 [] | Section: Fertility |
Just before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.9 [] | Section: Fertility |
And what about [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.9 [] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.9 [] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.9 [] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.9 [] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was born?
| Q12-86.9 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.9 [] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was born?
| Q12-88.9 [] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.9 [] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was born?
| Q12-90.9 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.9 [] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was born?
| Q12-92.9 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.9 [] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.9 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.9 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.9 [] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.9 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.9 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.9 [] | Section: Fertility |
([Q12-93.9]=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.9 [] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.9 [] | Section: Fertility |
([Q12-94.9]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.9 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.9 [] | Section: Fertility |
([Q12-95.9]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.9 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.9 [] | Section: Fertility |
([Q12-96.9]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.9 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.9 [] | Section: Fertility |
([Q12-97.9]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.9 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.9 [] | Section: Fertility |
([Q12-98.9]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.9 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.9 [] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] born within one week of the expected (due) date?
| Q12-106A.9 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.9 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.9 [] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.9 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.9 [] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.9 [] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]?
| Q12-111.9 [] | Section: Fertility |
(([[Q12-109.9]] >= 0) & ([[Q12-110.9]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.9) |
| Q12-112.9 [] | Section: Fertility |
([[Q12-109.9]] - [[Q12-110.9]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.9
| Q12-113.9 [] | Section: Fertility |
([[Q12-109.9]] < [[Q12-110.9]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.9 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain loss during pregnancy (pregnancy 9)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.9 ([Q12-109.9]) AND Q12-110.9 ([Q12-110.9]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-115.9 [] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain loss during pregnancy (pregnancy 9)] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.9 ([Q12-109.9]) AND Q12-110.9 ([Q12-110.9]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-116.9 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.9 ([Q12-109.9]) AND Q12-110.9 ([Q12-110.9]) AS NECESSARY <PG-UP> TO CORRECT IF R INDICATES AMOUNT IS INCORRECT.)
| Q12-117.9 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]?
| Q12-117A.9 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.9 [] | Section: Fertility |
How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.9 [] | Section: Fertility |
(How much did [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.9 [] | Section: Fertility |
What was [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s length at birth?
| Q12-119A.9 [] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.9 [] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.9) |
| Q12-120A.9 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.9
| Q12-121.9 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.9 [] | Section: Fertility |
How many days earlier?
| Q12-122B.9 [] | Section: Fertility |
How many days later?
| Q12-123.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| Q12-124.9 [] | Section: Fertility |
When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.9 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.9 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 9)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.9.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.9 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 9)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 9)]?
If Answer = 1 Then Go To Q12-129.9
| Q12-128.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 9)]?
| Q12-129.9 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, first time (pregnancy 9)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.9 [] | Section: Fertility |
([[Q12-129.9-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.9 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was admitted to the hospital, was surgery necessary?
| Q12-132.9 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.9 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.9 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.9 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 9)].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-134.9.)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.9 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 9)]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 9)]?
If Answer = 1 Then Go To Q12-139.9
| Q12-138.9 [] | Section: Fertility |
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 9)]?
| Q12-139.9 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [Main illness for which child born since last expanded fertility interview was taken to clinic, other time (pregnancy 9)], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.9 [] | Section: Fertility |
([[Q12-139.9-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.9 [] | Section: Fertility |
When [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] was admitted to the hospital, was surgery necessary?
| Q12-142.9 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.9 [] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| Q12-144.9 [] | Section: Fertility |
How many months old was [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(1)]] = 1)
COMMENT: Was first child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(2)]] = 2)
COMMENT: Was first child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(3)]] = 3)
COMMENT: Was first child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(4)]] = 4)
COMMENT: Was first child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(5)]] = 5)
COMMENT: Was first child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(6)]] = 6)
COMMENT: Was first child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(7)]] = 7)
COMMENT: Was first child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(8)]] = 8)
COMMENT: Was first child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(9)]] = 9)
COMMENT: Was first child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(10)]] = 10)
COMMENT: Was first child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(11)]] = 11)
COMMENT: Was first child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.9 [] | Section: Fertility |
([[Q12-144.9-CODEALL(12)]] = 12)
COMMENT: Was first child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.9 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.9 [] | Section: Fertility |
([Q12-30d.9] = 5) | ([Q12-30d.9] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-158A.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.9 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.9 [] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.9 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.9 [] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy since last expanded fertility interview (pregnancy 9)]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-158A.9 [] | Section: Fertility |
CHECK ([Name of biological child(10)])
COMMENT: check if to loop again 2nd time
If Answer = 1 Then Go To Q12-74.10
| Q12-74.10 [] | Section: Fertility |
Now I'd like to ask you some questions about [your/the] pregnancy(ies) that led to the birth of your [child/children]
(INTERVIEWER: HIGHLIGHT NAME OF THE CHILD WHO WAS TENTH BORN.)
| Q12-76A.10 [] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check gender
If Answer = 1 Then Go To Q12-78M.10
| Q12-77F.10 [] | Section: Fertility |
When did you become pregnant with [Name of child from pregnancy 10]? What month and year?
| Q12-78F.10 [] | Section: Fertility |
(HAND CARD CC) Just before you became pregnant with [Name of child from pregnancy 10], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79F.10 [] | Section: Fertility |
Had you stopped all methods before you became pregnant?
| Q12-80F.10 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted to become pregnant?
| Q12-81F.10 [] | Section: Fertility |
Just before you became pregnant that time, did you want to become pregnant when you did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82F.10 [] | Section: Fertility |
And what about your spouse or partner when you became pregnant that time, did he want to have (a/another) baby?
(IF NO, PROBE:) Did he want to have (a/another) baby but not at that time, or did he want to have
(none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-78M.10 [] | Section: Fertility |
(HAND CARD CC) Just before [Name of child from pregnancy 10]'s mother became pregnant with [Name of child from pregnancy 10], did you use any methods such as the ones listed on this card to keep from getting pregnant?
| Q12-79M.10 [] | Section: Fertility |
Had you stopped all methods before [Name of child from pregnancy 10]'s mother became pregnant?
| Q12-80M.10 [] | Section: Fertility |
Was the reason you [blank/were not/stopped] using any methods because you yourself wanted [Name of child from pregnancy 10]'s mother to become pregnant?
| Q12-81M.10 [] | Section: Fertility |
Just before [Name of child from pregnancy 10]'s mother became pregnant that time, did you want her to become pregnant when she did?
(IF NO, PROBE:) Did you want (a/another) baby but not at that time, or did you want (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82M.10 [] | Section: Fertility |
And what about [Name of child from pregnancy 10]'s mother when she became pregnant that time -- did she want to have (a/another) baby?
(IF NO, PROBE ) Did she want to have (a/another) baby but not at that time, or did she want to have (none/no more) at all?
| | 1 Yes |
| | 2 Didn't matter |
| | 3 No--not at that time |
| | 4 No--(none/no more) at all |
| Q12-82N.10 [] | Section: Fertility |
([[Gender of the respondent]]=1)
COMMENT: check if male
| | 1 CONDITION APPLIES ...(Go To Q12-157BA.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-83.10 [] | Section: Fertility |
During your pregnancy with [Name of child from pregnancy 10], did you make any visits to a doctor or nurse for prenatal care, that is, to be examined or talk about your pregnancy?
| Q12-84.10 [] | Section: Fertility |
When did you first visit a doctor or nurse for prenatal care -- during which month of your pregnancy?
(ENTER MONTH NUMBER)
| Q12-85.10 [] | Section: Fertility |
Did you drink any alcoholic beverages, including beer, wine, or liquor, during the 12 months before [Name of child from pregnancy 10] was born?
| Q12-86.10 [] | Section: Fertility |
(HAND CARD DD) How often did you usually drink alcoholic beverages during (your/that) pregnancy? Did you drink ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-87.10 [] | Section: Fertility |
Did you smoke tobacco cigarettes at all during the 12 months before [Name of child from pregnancy 10] was born?
| Q12-88.10 [] | Section: Fertility |
On the average, how many cigarettes did you smoke during (your/that) pregnancy? Did you smoke 2 or more packs a day? Did you smoke 1 pack or more but less than 2 packs a day, or less than 1 pack a day?
| | 3 2 or more packs a day |
| | 2 1 or more but less than 2 |
| | 1 Less than 1 pack a day |
| | 0 (IF VOLUNTEERED:) DID NOT SMOKE DURING THAT PERIOD |
| Q12-89.10 [] | Section: Fertility |
Did you use marijuana or hashish at all during the 12 months before [Name of child from pregnancy 10] was born?
| Q12-90.10 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use marijuana or hashish during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-91.10 [] | Section: Fertility |
Did you use any form of cocaine at all during the 12 months before [Name of child from pregnancy 10] was born?
| Q12-92.10 [] | Section: Fertility |
(HAND CARD DD) On the average, how many times did you usually use any form of cocaine during (your/that) pregnancy? Did you use it ... (READ CATEGORIES)...?
| | 7 Every day |
| | 6 Nearly every day |
| | 5 3 or 4 days a week |
| | 4 1 or 2 days a week |
| | 3 3 or 4 days a month |
| | 2 About once a month |
| | 1 Less than once a month |
| | 0 Never |
| Q12-93.10 [] | Section: Fertility |
During (your/that) pregnancy, did you take a vitamin/mineral supplement?
| Q12-94.10 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of calories in the food you ate?
| Q12-95.10 [] | Section: Fertility |
During (your/that) pregnancy, did you cut down on the amount of salt you used?
| Q12-96.10 [] | Section: Fertility |
During (your/that) pregnancy, did you use diuretics (fluid or water pills) to help eliminate water?
| Q12-97.10 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your smoking?
| Q12-98.10 [] | Section: Fertility |
During (your/that) pregnancy, did you reduce or stop your alcohol intake?
| Q12-99A.10 [] | Section: Fertility |
([Q12-93.10=1)
COMMENT: Did R take a vitamin/mineral supplement during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-99B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-99B.10 [] | Section: Fertility |
Did you take a vitamin/mineral supplement based on a doctor's or nurse's suggestion?
| Q12-100A.10 [] | Section: Fertility |
([Q12-94.10]=1)
COMMENT: Did R cut down on the amount of calories his/her food during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-100B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-100B.10 [] | Section: Fertility |
Did you cut down on the amount of calories in the food you ate based on a doctor's or nurse's suggestion?
| Q12-101A.10 [] | Section: Fertility |
([Q12-95.10]=1)
COMMENT: Did R cut down on the amount of salt he/she used during first
pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-101B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-101B.10 [] | Section: Fertility |
Did you cut down on the amount of salt you used based on a doctor's or nurse's suggestion?
| Q12-102A.10 [] | Section: Fertility |
([Q12-96.10]=1)
COMMENT: Did R use diuretics (fluid or water pills) to help eliminate water
during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-102B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-102B.10 [] | Section: Fertility |
Did you use diuretics (fluid or water pills) to help eliminate water based on a doctor's or nurse's suggestion?
| Q12-103A.10 [] | Section: Fertility |
([Q12-97.10]=1)
COMMENT: Did R reduce or stop his/her smoking during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-103B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-103B.10 [] | Section: Fertility |
Did you reduce or stop your smoking based on a doctor's or nurse's suggestion?
| Q12-104A.10 [] | Section: Fertility |
([Q12-98.10]=1)
COMMENT: Did R reduce or stop his/her alcohol intake during first pregnancy?
| | 1 CONDITION APPLIES ...(Go To Q12-104B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-104B.10 [] | Section: Fertility |
Did you reduce or stop your alcohol intake based on a doctor's or nurse's suggestion?
| Q12-105.10 [] | Section: Fertility |
Based on either your last menstrual period date or your doctor's or clinic's information, was [Name of child from pregnancy 10] born within one week of the expected (due) date?
| Q12-106A.10 [] | Section: Fertility |
Was the baby born early or late?
| Q12-106B.10 [] | Section: Fertility |
How many weeks [early/late] was the baby?
(IF "1 1/2 WEEKS" ROUND UP TO "2".)
| Q12-107.10 [] | Section: Fertility |
Was a cesarean section done?
(IF NECESSARY, PROBE:) Was the baby delivered by an incision in your abdomen?
| Q12-108.10 [] | Section: Fertility |
Was this your first cesarean section, or did you have one before?
| | 1 First cesarean |
| | 0 Had cesarean(s) before |
| Q12-109.10 [] | Section: Fertility |
What was your weight just before you delivered?
| Q12-110.10 [] | Section: Fertility |
What was your weight just before you became pregnant with [Name of child from pregnancy 10]?
| Q12-111.10 [] | Section: Fertility |
(([[Q12-109.10]] >= 0) & ([[Q12-110.10]] >= 0))
COMMENT: Are both the weight at delivery and the pre-pregnancy weight real
numbers (not DK or REFUSALS)?
| | 1 CONDITION APPLIES |
| | 0 CONDITION DOES NOT APPLY ...(Go To Q12-118A.10) |
| Q12-112.10 [] | Section: Fertility |
([[Q12-109.10]] - [[Q12-110.10]])
COMMENT: Subtract weight at time of delivery from weight before pregnancy.
If Answer = 0 Then Go To Q12-116.10
| Q12-113.10 [] | Section: Fertility |
([[Q12-109.10]] < [[Q12-110.10]])
COMMENT: Did R lose weight during pregnancy (weight at delivery is less than
weight before pregnancy)?
| Q12-114B.10 [] | Section: Fertility |
Does that mean that you lost [Respondent's weight gain/loss during pregnancy 10] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.10 ([Q12-109.10]) AND Q12-110.10 ([Q12-110.10]) IF INCORRECT.)
| Q12-115.10 [] | Section: Fertility |
Does that mean that you gained [Respondent's weight gain/loss during pregnancy 10] pounds during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.10 ([Q12-109.10]) AND Q12-110.10 ([Q12-110.10]) IF INCORRECT.)
| Q12-116.10 [] | Section: Fertility |
Does that mean that you did not gain or lose any weight during your pregnancy?
(INTERVIEWER: VERIFY WEIGHTS IN Q12-109.10 ([Q12-109.10]) AND Q12-110.10 ([Q12-110.10]) IF INCORRECT.)
| Q12-117.10 [] | Section: Fertility |
Did you gain or lose weight during your pregnancy with [Name of child from pregnancy 10]?
| Q12-117A.10 [] | Section: Fertility |
How much weight did you [gain/lose]?
(ENTER NUMBER OF POUNDS)
| Q12-118A.10 [] | Section: Fertility |
How much did [Name of child from pregnancy 10] weigh at birth?
(ENTER NUMBER OF POUNDS AND PRESS <ENTER> TO ENTER OUNCES.)
| Q12-118B.10 [] | Section: Fertility |
(How much did [Name of child from pregnancy 10] weigh at birth?)
(ENTER NUMBER OF OUNCES.)
| Q12-119.10 [] | Section: Fertility |
What was [Name of child from pregnancy 10]'s length at birth?
| Q12-119A.10 [] | Section: Fertility |
INTERVIEWER: DID R INDICATE THAT THE LENGTH OF THE BABY WAS AN ESTIMATE?
| Q12-120.10 [] | Section: Fertility |
How long did your baby stay in the hospital?
| | 1 SELECT TO ENTER NUMBER OF DAYS |
| | 0 BABY/RESPONDENT DID NOT STAY IN HOSPITAL ...(Go To Q12-123.10) |
| Q12-120A.10 [] | Section: Fertility |
(ENTER NUMBER OF DAYS:)
If Answer = 0 Then Go To Q12-123.10
| Q12-121.10 [] | Section: Fertility |
Did you leave the hospital at the same time as your baby or did you leave earlier or later?
| Q12-122A.10 [] | Section: Fertility |
How many days earlier?
| Q12-122B.10 [] | Section: Fertility |
How many days later?
| Q12-123.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured?
| | 1 Yes ...(Go To Q12-124.10) |
| | 0 No |
| | 2 BABY DIED IN FIRST YEAR ...(Go To Q12-160) |
| | 3 BABY ADOPTED OUT IN FIRST YEAR ...(Go To Q12-160) |
| Q12-124.10 [] | Section: Fertility |
When you took [Name of child from pregnancy 10] to a clinic, hospital, or doctor the first time because (he/she) was sick or injured, what was the nature of (his/her) illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-124A.10 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-125.10 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [first illness of child from pregnancy 10].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-124.10)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-126.10 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 10] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [first illness of child from pregnancy 10]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-127.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 10]?
If Answer = 1 Then Go To Q12-129.10
| Q12-128.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [first illness of child from pregnancy 10]?
| Q12-129.10 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 10]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [first illness of child from pregnancy 10], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-130B.10 [] | Section: Fertility |
([[Q12-129.10-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for first illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-131.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-131.10 [] | Section: Fertility |
When [Name of child from pregnancy 10] was admitted to the hospital, was surgery necessary?
| Q12-132.10 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-133.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, did you take (him/her) to a clinic, hospital, or doctor because (he/she) was sick or injured with a different illness or injury than the one we have just talked about?
| Q12-134.10 [] | Section: Fertility |
What was the nature of this other illness or injury?
(INTERVIEWER: RECODE VERBATIM. PRESS <ENTER> TO CONTINUE FOR CODING OF
ILLNESS OR INJURY DESCRIBED HERE.)
| Q12-134A.10 [] | Section: Fertility |
(INTERVIEWER: CODE FOR MAIN ILLNESS OR INJURY. PRESS <ENTER> TO CODE OTHER SYMPTOMS MENTIONED FOR THIS ILLNESSES OR INJURIES.)
(IF MORE THAN ONE ILLNESS OR INJURY MENTIONED, PROBE:) What was the main illness or injury?
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-135.10 [] | Section: Fertility |
(HAND CARD EE) Please look at this card and tell me which of these symptoms or conditions occurred with (the/a) [second illness of child from pregnancy 10].
(INTERVIEWER: CODE ALL THAT APPLY. DO NOT RECODE MAIN ILLNESS OR INJURY
RECORDED IN 12-134.10)
| | 1 Fever |
| | 2 Cold |
| | 3 Sore throat |
| | 4 Pneumonia |
| | 5 Ear infection |
| | 6 Vomiting, diarrhea, or dehydration |
| | 7 Rash |
| | 8 Accident or poisoning |
| | 9 Convulsions |
| | 10 Jaundice |
| | 11 Feeding problems (food allergy, formula tolerance, etc.) |
| | 12 Meningitis |
| | 13 Asthma or bronchitis |
| | 14 Other (SPECIFY) |
| | 0 None |
| Q12-136.10 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 10] when you took (him/her) to a clinic, hospital or doctor the first time for (this) [second illness of child from pregnancy 10]?
(INTERVIEWER: 1 DAY TO 4 WKS = 1 MONTH. MORE THAN 4 WEEKS -- DIVIDE BY 4 AND ROUND UP. EX: 35 WEEKS = 9 MONTHS.)
| Q12-137.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, altogether how many visits were made to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 10]?
If Answer = 1 Then Go To Q12-139.10
| Q12-138.10 [] | Section: Fertility |
In [Name of child from pregnancy 10]'s first year, how many months old was (he/she) the last time you took (him/her) to a clinic or doctor for (that) [second illness of child from pregnancy 10]?
| Q12-139.10 [] | Section: Fertility |
(HAND CARD FF) Please look at this card. In [Name of child from pregnancy 10]'s first year, when you took (him/her) to a clinic, hospital, or doctor because (he/she) had (that) [second illness of child from pregnancy 10], where did you take (him/her)?
(CODE ALL THAT APPLY)
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-140B.10 [] | Section: Fertility |
([[Q12-139.10-CODEALL(9)]] = 9)
COMMENT: Was child from first pregnancy admitted to hospital for second illness
in first year of life?
| | 1 CONDITION APPLIES ...(Go To Q12-141.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-141.10 [] | Section: Fertility |
When [Name of child from pregnancy 10] was admitted to the hospital, was surgery necessary?
| Q12-142.10 [] | Section: Fertility |
Did you have to take time off from work?
| Q12-143.10 [] | Section: Fertility |
Now we are going to discuss well baby care.
In [Name of child from pregnancy 10]'s first year, did you take (him/her) to a clinic or doctor for well baby care when (he/she) was not sick?
| | 1 Yes ...(Go To Q12-144.10) |
| | 0 No |
| | 2 BABY DIED IN FIRST YEAR ...(Go To Q12-160) |
| | 3 BABY ADOPTED OUT IN FIRST YEAR ...(Go To Q12-160) |
| Q12-144.10 [] | Section: Fertility |
How many months old was [Name of child from pregnancy 10] when you took (him/her) to a clinic or doctor for well baby care the first time?.....
How old was (he/she) the next time?
(INTERVIEWER: CONTINUE TO ASK UNTIL THE LAST TIME IS CODED. MARK ALL THAT APPLY.)
| | 1 01 - ONE MONTH OLD |
| | 2 02 - TWO MONTHS OLD |
| | 3 03 - THREE MONTHS OLD |
| | 4 04 - FOUR MONTHS OLD |
| | 5 05 - FIVE MONTHS OLD |
| | 6 06 - SIX MONTHS OLD |
| | 7 07 - SEVEN MONTHS OLD |
| | 8 08 - EIGHT MONTHS OLD |
| | 9 09 - NINE MONTHS OLD |
| | 10 10 - TEN MONTHS OLD |
| | 11 11 - ELEVEN MONTHS OLD |
| | 12 12 - TWELVE MONTHS OLD |
| Q12-146A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(7)]] = 1)
COMMENT: Was first child taken for well baby care in his first month?
| | 1 CONDITION APPLIES ...(Go To Q12-146B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-146B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 1 month old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-147A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(2)]] = 2)
COMMENT: Was first child taken for well baby care in his second month?
| | 1 CONDITION APPLIES ...(Go To Q12-147B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-147B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 2 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-148A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(3)]] = 3)
COMMENT: Was first child taken for well baby care in his third month?
| | 1 CONDITION APPLIES ...(Go To Q12-148B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-148B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 3 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-149A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(4)]] = 4)
COMMENT: Was first child taken for well baby care in his fourth month?
| | 1 CONDITION APPLIES ...(Go To Q12-149B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-149B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 4 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-150A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(7)]] = 5)
COMMENT: Was first child taken for well baby care in his fifth month?
| | 1 CONDITION APPLIES ...(Go To Q12-150B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-150B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 5 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-151A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(7)]] = 6)
COMMENT: Was first child taken for well baby care in his sixth month?
| | 1 CONDITION APPLIES ...(Go To Q12-151B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-151B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 6 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-152A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(7)]] = 7)
COMMENT: Was first child taken for well baby care in his seventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-152B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-152B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 7 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-153A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(10)]] = 8)
COMMENT: Was first child taken for well baby care in his eighth month?
| | 1 CONDITION APPLIES ...(Go To Q12-153B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-153B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 8 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-154A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(10)]] = 9)
COMMENT: Was first child taken for well baby care in his ninth month?
| | 1 CONDITION APPLIES ...(Go To Q12-154B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-154B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 9 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-155A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(10)]] = 10)
COMMENT: Was first child taken for well baby care in his tenth month?
| | 1 CONDITION APPLIES ...(Go To Q12-155B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-155B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 10 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-156A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(11)]] = 11)
COMMENT: Was first child taken for well baby care in his eleventh month?
| | 1 CONDITION APPLIES ...(Go To Q12-156B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-156B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 11 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157A.10 [] | Section: Fertility |
([[Q12-144.10-CODEALL(12)]] = 12)
COMMENT: Was first child taken for well baby care in his twelveth month?
| | 1 CONDITION APPLIES ...(Go To Q12-157B.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157B.10 [] | Section: Fertility |
(HAND CARD FF) When you took [Name of child from pregnancy 10] for well baby care when (he/she) was 12 months old, where did you take (him/her)? Was it a.... (READ CATEGORIES AS NECESSARY)?
| | 1 Private doctor's office |
| | 2 Public clinic |
| | 3 Private clinic |
| | 4 Health maintenance organization (HMO) |
| | 5 Hospital clinic, walk-in clinic |
| | 6 Community health center |
| | 7 Emergency room out-patient |
| | 8 Other (SPECIFY) |
| | 9 Hospital admission |
| Q12-157BA.10 [] | Section: Fertility |
([Q12-30d.10] = 5) | ([Q12-30d.10] = 8)
COMMENT: if child is adopted out or deceased
| | 1 CONDITION APPLIES ...(Go To Q12-160) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-157C.10 [] | Section: Fertility |
Now, we have a few questions about health care plans. First, is [Name of child from pregnancy 10]'s health insurance provided either by an employer or by an individual plan that pays part of or all of a hospital bill?...........
| Q12-157CA.10 [] | Section: Fertility |
.....(PROBE IF NECESSARY) Examples of health and hospitalization insurance plan include Blue Cross, Blue Shield, HMO. [THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.]
| Q12-157D.10 [] | Section: Fertility |
(HAND CARD GG) What is the source of [Name of child from pregnancy 10]'s health plan? Is it your own policy bought directly from a medical insurance company, your parent's policy, an employer policy, or something else?
| | 1 Respondent's Parent's policy |
| | 2 Respondent/spouse/partner policy bought directly from insurance company |
| | 3 Respondent's employer policy |
| | 4 Spouse/partner employer policy |
| | 5 Other (SPECIFY) |
| Q12-157E.10 [] | Section: Fertility |
There is a national program called Medicaid (Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is [Name of child from pregnancy 10]'s health care now covered by Medicaid or one of these public assistance health care programs?
| Q12-160 [Y02730.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check the gender of the respondent
If Answer = 1 Then Go To Q12-170
| Default Next: | Q12-161.1 |
| Lead-In: | Q12-121.10 [5:6], Q12-123.10 [2:3], Q12-143.10 [2:3], Q12-157BA.10 [1:1], Q12-158A.1 [Default], Q12-158A.2 [Default], Q12-158A.3 [Default], Q12-158A.4 [Default], Q12-158A.5 [Default], Q12-158A.6 [Default], Q12-158A.7 [Default], Q12-158A.8 [Default], Q12-158A.9 [Default], Q12-157E.10 [Default] |
| Q12-161.1 [Y02731.00] | Section: Fertility |
CHECK ([Name of biological child(1)])
COMMENT: Is there a first child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.1 [Y02732.00] | Section: Fertility |
When [Name of biological child(1)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.1 [Y02733.00] | Section: Fertility |
How many weeks old was [Name of biological child(1)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.1) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.1) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.1 [Y02734.00] | Section: Fertility |
(How many weeks old was [Name of biological child(1)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.1 [Y02735.00] | Section: Fertility |
(How many months old was [Name of biological child(1)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.1 [Y02736.00] | Section: Fertility |
How many weeks old was [Name of biological child(1)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.1) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.1) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.1) |
| Q12-166A.1 [Y02737.00] | Section: Fertility |
(How many weeks old was [Name of biological child(1)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.1 [Y02738.00] | Section: Fertility |
(How many months old was [Name of biological child(1)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.1 [Y02739.03] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.1 [Y02751.00] | Section: Fertility |
How many weeks old was [Name of biological child(1)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.1) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.1) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.1 [Y02752.00] | Section: Fertility |
(How many weeks old was [Name of biological child(1)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.1 [Y02753.00] | Section: Fertility |
(How many months old was [Name of biological child(1)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.1 [Y02754.00] | Section: Fertility |
How many weeks old was [Name of biological child(1)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.1) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.1) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.1 [Y02755.00] | Section: Fertility |
(How many weeks old was [Name of biological child(1)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.1 [Y02756.00] | Section: Fertility |
(How many months old was [Name of biological child(1)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.1 [Y02757.00] | Section: Fertility |
([Q12-164.1]=1) | ([Q12-166.1]=0) | ([Q12-167.1]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.1) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.1 [Y02758.00] | Section: Fertility |
How (was/is) [Name of biological child(1)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.1 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.1 [Y02759.00] | Section: Fertility |
How many weeks old was [Name of biological child(1)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.1) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.1) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.1 [Y02760.00] | Section: Fertility |
(How many weeks old was [Name of biological child(1)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.1 [Y02761.00] | Section: Fertility |
(How many months old was [Name of biological child(1)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.2 [Y02762.00] | Section: Fertility |
CHECK ([Name of biological child(2)])
COMMENT: Is there a 2nd child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.2 [Y02763.00] | Section: Fertility |
When [Name of biological child(2)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.2 [Y02764.00] | Section: Fertility |
How many weeks old was [Name of biological child(2)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.2) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.2) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.2 [] | Section: Fertility |
(How many weeks old was [Name of biological child(2)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.2 [Y02765.00] | Section: Fertility |
(How many months old was [Name of biological child(2)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.2 [Y02766.00] | Section: Fertility |
How many weeks old was [Name of biological child(2)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.2) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.2) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.2) |
| Q12-166A.2 [Y02767.00] | Section: Fertility |
(How many weeks old was [Name of biological child(2)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.2 [Y02768.00] | Section: Fertility |
(How many months old was [Name of biological child(2)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.2 [Y02769.07] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.2 [Y02781.00] | Section: Fertility |
How many weeks old was [Name of biological child(2)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.2) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.2) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.2 [Y02782.00] | Section: Fertility |
(How many weeks old was [Name of biological child(2)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.2 [Y02783.00] | Section: Fertility |
(How many months old was [Name of biological child(2)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.2 [Y02784.00] | Section: Fertility |
How many weeks old was [Name of biological child(2)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.2) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.2) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.2 [Y02785.00] | Section: Fertility |
(How many weeks old was [Name of biological child(2)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.2 [Y02786.00] | Section: Fertility |
(How many months old was [Name of biological child(2)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.2 [Y02787.00] | Section: Fertility |
([Q12-164.2]=1) | ([Q12-166.2]=0) | ([Q12-167.2]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.2) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.2 [Y02788.00] | Section: Fertility |
How (was/is) [Name of biological child(2)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.2 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.2 [Y02789.00] | Section: Fertility |
How many weeks old was [Name of biological child(2)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.2) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.2) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.2 [Y02790.00] | Section: Fertility |
(How many weeks old was [Name of biological child(2)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.2 [Y02791.00] | Section: Fertility |
(How many months old was [Name of biological child(2)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.3 [Y02792.00] | Section: Fertility |
CHECK ([Name of biological child(3)])
COMMENT: Is there a 3rd child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.3 [Y02793.00] | Section: Fertility |
When [Name of biological child(3)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.3 [Y02794.00] | Section: Fertility |
How many weeks old was [Name of biological child(3)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.3) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.3) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.3 [] | Section: Fertility |
(How many weeks old was [Name of biological child(3)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.3 [Y02795.00] | Section: Fertility |
(How many months old was [Name of biological child(3)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.3 [Y02796.00] | Section: Fertility |
How many weeks old was [Name of biological child(3)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.3) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.3) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.3) |
| Q12-166A.3 [] | Section: Fertility |
(How many weeks old was [Name of biological child(3)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.3 [Y02797.00] | Section: Fertility |
(How many months old was [Name of biological child(3)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.3 [Y02798.07] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.3 [Y02810.00] | Section: Fertility |
How many weeks old was [Name of biological child(3)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.3) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.3) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.3 [] | Section: Fertility |
(How many weeks old was [Name of biological child(3)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.3 [Y02811.00] | Section: Fertility |
(How many months old was [Name of biological child(3)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.3 [Y02812.00] | Section: Fertility |
How many weeks old was [Name of biological child(3)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.3) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.3) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.3 [] | Section: Fertility |
(How many weeks old was [Name of biological child(3)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.3 [Y02813.00] | Section: Fertility |
(How many months old was [Name of biological child(3)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.3 [Y02814.00] | Section: Fertility |
([Q12-164.3]=1) | ([Q12-166.3]=0) | ([Q12-167.3]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.3) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.3 [Y02815.00] | Section: Fertility |
How (was/is) [Name of biological child(3)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.3 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.3 [Y02816.00] | Section: Fertility |
How many weeks old was [Name of biological child(3)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.3) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.3) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.3 [Y02817.00] | Section: Fertility |
(How many weeks old was [Name of biological child(3)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.3 [Y02818.00] | Section: Fertility |
(How many months old was [Name of biological child(3)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.4 [Y02819.00] | Section: Fertility |
CHECK ([Name of biological child(4)])
COMMENT: Is there a 4th child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.4 [Y02820.00] | Section: Fertility |
When [Name of biological child(4)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.4 [Y02821.00] | Section: Fertility |
How many weeks old was [Name of biological child(4)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.4) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.4) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.4 [] | Section: Fertility |
(How many weeks old was [Name of biological child(4)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.4 [Y02822.00] | Section: Fertility |
(How many months old was [Name of biological child(4)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.4 [Y02823.00] | Section: Fertility |
How many weeks old was [Name of biological child(4)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.4) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.4) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.4) |
| Q12-166A.4 [] | Section: Fertility |
(How many weeks old was [Name of biological child(4)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.4 [] | Section: Fertility |
(How many months old was [Name of biological child(4)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.4 [Y02824.06] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.4 [Y02836.00] | Section: Fertility |
How many weeks old was [Name of biological child(4)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.4) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.4) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.4 [] | Section: Fertility |
(How many weeks old was [Name of biological child(4)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.4 [Y02837.00] | Section: Fertility |
(How many months old was [Name of biological child(4)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.4 [Y02838.00] | Section: Fertility |
How many weeks old was [Name of biological child(4)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.4) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.4) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.4 [] | Section: Fertility |
(How many weeks old was [Name of biological child(4)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.4 [Y02839.00] | Section: Fertility |
(How many months old was [Name of biological child(4)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.4 [Y02840.00] | Section: Fertility |
([Q12-164.4]=1) | ([Q12-166.4]=0) | ([Q12-167.4]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.4) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.4 [] | Section: Fertility |
How (was/is) [Name of biological child(4)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.4 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.4 [Y02841.00] | Section: Fertility |
How many weeks old was [Name of biological child(4)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.4) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.4) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.4 [Y02842.00] | Section: Fertility |
(How many weeks old was [Name of biological child(4)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.4 [Y02843.00] | Section: Fertility |
(How many months old was [Name of biological child(4)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.5 [Y02844.00] | Section: Fertility |
CHECK ([Name of biological child(5)])
COMMENT: Is there a 5th child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.5 [Y02845.00] | Section: Fertility |
When [Name of biological child(5)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.5 [Y02846.00] | Section: Fertility |
How many weeks old was [Name of biological child(5)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.5) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.5) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.5 [] | Section: Fertility |
(How many weeks old was [Name of biological child(5)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.5 [Y02847.00] | Section: Fertility |
(How many months old was [Name of biological child(5)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.5 [Y02848.00] | Section: Fertility |
How many weeks old was [Name of biological child(5)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.5) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.5) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.5) |
| Q12-166A.5 [] | Section: Fertility |
(How many weeks old was [Name of biological child(5)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.5 [] | Section: Fertility |
(How many months old was [Name of biological child(5)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.5 [Y02849.07] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.5 [Y02861.00] | Section: Fertility |
How many weeks old was [Name of biological child(5)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.5) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.5) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.5 [] | Section: Fertility |
(How many weeks old was [Name of biological child(5)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.5 [Y02862.00] | Section: Fertility |
(How many months old was [Name of biological child(5)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.5 [Y02863.00] | Section: Fertility |
How many weeks old was [Name of biological child(5)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.5) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.5) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.5 [] | Section: Fertility |
(How many weeks old was [Name of biological child(5)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.5 [Y02864.00] | Section: Fertility |
(How many months old was [Name of biological child(5)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.5 [Y02865.00] | Section: Fertility |
([Q12-164.5]=1) | ([Q12-166.5]=0) | ([Q12-167.5]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.5) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.5 [] | Section: Fertility |
How (was/is) [Name of biological child(5)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.5 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.5 [Y02866.00] | Section: Fertility |
How many weeks old was [Name of biological child(5)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.5) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.5) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.5 [Y02867.00] | Section: Fertility |
(How many weeks old was [Name of biological child(5)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.5 [] | Section: Fertility |
(How many months old was [Name of biological child(5)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.6 [Y02868.00] | Section: Fertility |
CHECK ([Name of biological child(6)])
COMMENT: Is there a 6th child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.6 [Y02869.00] | Section: Fertility |
When [Name of biological child(6)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.6 [Y02870.00] | Section: Fertility |
How many weeks old was [Name of biological child(6)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.6) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.6) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.6 [] | Section: Fertility |
(How many weeks old was [Name of biological child(6)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.6 [] | Section: Fertility |
(How many months old was [Name of biological child(6)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.6 [Y02871.00] | Section: Fertility |
How many weeks old was [Name of biological child(6)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.6) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.6) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.6) |
| Q12-166A.6 [] | Section: Fertility |
(How many weeks old was [Name of biological child(6)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.6 [] | Section: Fertility |
(How many months old was [Name of biological child(6)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.6 [Y02872.09] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.6 [Y02884.00] | Section: Fertility |
How many weeks old was [Name of biological child(6)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.6) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.6) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.6 [] | Section: Fertility |
(How many weeks old was [Name of biological child(6)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.6 [] | Section: Fertility |
(How many months old was [Name of biological child(6)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.6 [Y02885.00] | Section: Fertility |
How many weeks old was [Name of biological child(6)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.6) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.6) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.6 [] | Section: Fertility |
(How many weeks old was [Name of biological child(6)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.6 [] | Section: Fertility |
(How many months old was [Name of biological child(6)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.6 [Y02886.00] | Section: Fertility |
([Q12-164.6]=1) | ([Q12-166.6]=0) | ([Q12-167.6]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.6) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.6 [] | Section: Fertility |
How (was/is) [Name of biological child(6)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.6 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.6 [Y02887.00] | Section: Fertility |
How many weeks old was [Name of biological child(6)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.6) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.6) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.6 [] | Section: Fertility |
(How many weeks old was [Name of biological child(6)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.6 [] | Section: Fertility |
(How many months old was [Name of biological child(6)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.7 [Y02888.00] | Section: Fertility |
CHECK ([Name of biological child(7)])
COMMENT: Is there a 7th child to check?
| | 1 CONDITION APPLIES ...(Go To Q12-164.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-164.7 [] | Section: Fertility |
When [Name of biological child(7)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.7 [] | Section: Fertility |
How many weeks old was [Name of biological child(7)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.7) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.7) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.7 [] | Section: Fertility |
(How many weeks old was [Name of biological child(7)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.7 [] | Section: Fertility |
(How many months old was [Name of biological child(7)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.7 [] | Section: Fertility |
How many weeks old was [Name of biological child(7)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.7) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.7) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.7) |
| Q12-166A.7 [] | Section: Fertility |
(How many weeks old was [Name of biological child(7)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.7 [] | Section: Fertility |
(How many months old was [Name of biological child(7)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.7 [] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.7 [] | Section: Fertility |
How many weeks old was [Name of biological child(7)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.7) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.7) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.7 [] | Section: Fertility |
(How many weeks old was [Name of biological child(7)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.7 [] | Section: Fertility |
(How many months old was [Name of biological child(7)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.7 [] | Section: Fertility |
How many weeks old was [Name of biological child(7)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.7) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.7) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.7 [] | Section: Fertility |
(How many weeks old was [Name of biological child(7)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.7 [] | Section: Fertility |
(How many months old was [Name of biological child(7)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.7 [] | Section: Fertility |
([Q12-164.7]=1) | ([Q12-166.7]=0) | ([Q12-167.7]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.7) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.7 [] | Section: Fertility |
How (was/is) [Name of biological child(7)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.7 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.7 [] | Section: Fertility |
How many weeks old was [Name of biological child(7)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.7) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.7) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.7 [] | Section: Fertility |
(How many weeks old was [Name of biological child(7)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.7 [] | Section: Fertility |
(How many months old was [Name of biological child(7)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.8 [] | Section: Fertility |
CHECK ([Name of biological child(8)])
COMMENT: Is there an 8th child to check?
If Answer = 1 Then Go To Q12-164.8
| Q12-164.8 [] | Section: Fertility |
When [Name of biological child(8)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.8 [] | Section: Fertility |
How many weeks old was [Name of biological child(8)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.8) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.8) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.8 [] | Section: Fertility |
(How many weeks old was [Name of biological child(8)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.8 [] | Section: Fertility |
(How many months old was [Name of biological child(8)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.8 [] | Section: Fertility |
How many weeks old was [Name of biological child(8)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.8) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.8) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.8) |
| Q12-166A.8 [] | Section: Fertility |
(How many weeks old was [Name of biological child(8)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.8 [] | Section: Fertility |
(How many months old was [Name of biological child(8)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.8 [] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.8 [] | Section: Fertility |
How many weeks old was [Name of biological child(8)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.8) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.8) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.8 [] | Section: Fertility |
(How many weeks old was [Name of biological child(8)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.8 [] | Section: Fertility |
(How many months old was [Name of biological child(8)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.8 [] | Section: Fertility |
How many weeks old was [Name of biological child(8)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.8) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.8) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.8 [] | Section: Fertility |
(How many weeks old was [Name of biological child(8)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.8 [] | Section: Fertility |
(How many months old was [Name of biological child(8)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.8 [] | Section: Fertility |
([Q12-164.8]=1) | ([Q12-166.8]=0) | ([Q12-167.8]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.8) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.8 [] | Section: Fertility |
How (was/is) [Name of biological child(8)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.8 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.8 [] | Section: Fertility |
How many weeks old was [Name of biological child(8)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.8) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.8) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.8 [] | Section: Fertility |
(How many weeks old was [Name of biological child(8)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.8 [] | Section: Fertility |
(How many months old was [Name of biological child(8)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.9 [] | Section: Fertility |
CHECK ([Name of biological child(9)])
COMMENT: Is there a 9th child to check?
If Answer = 1 Then Go To Q12-164.9
| Q12-164.9 [] | Section: Fertility |
When [Name of biological child(9)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.9 [] | Section: Fertility |
How many weeks old was [Name of biological child(9)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.9) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.9) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.9 [] | Section: Fertility |
(How many weeks old was [Name of biological child(9)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.9 [] | Section: Fertility |
(How many months old was [Name of biological child(9)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.9 [] | Section: Fertility |
How many weeks old was [Name of biological child(9)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.9) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.9) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.9) |
| Q12-166A.9 [] | Section: Fertility |
(How many weeks old was [Name of biological child(9)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.9 [] | Section: Fertility |
(How many months old was [Name of biological child(9)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.9 [] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.9 [] | Section: Fertility |
How many weeks old was [Name of biological child(9)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.9) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.9) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.9 [] | Section: Fertility |
(How many weeks old was [Name of biological child(9)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.9 [] | Section: Fertility |
(How many months old was [Name of biological child(9)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.9 [] | Section: Fertility |
How many weeks old was [Name of biological child(9)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.9) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.9) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.9 [] | Section: Fertility |
(How many weeks old was [Name of biological child(9)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.9 [] | Section: Fertility |
(How many months old was [Name of biological child(9)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.9 [] | Section: Fertility |
([Q12-164.9]=1) | ([Q12-166.9]=0) | ([Q12-167.9]=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.9) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.9 [] | Section: Fertility |
How (was/is) [Name of biological child(9)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.9 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.9 [] | Section: Fertility |
How many weeks old was [Name of biological child(9)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.9) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.9) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.9 [] | Section: Fertility |
(How many weeks old was [Name of biological child(9)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.9 [] | Section: Fertility |
(How many months old was [Name of biological child(9)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-161.10 [] | Section: Fertility |
CHECK ([Name of biological child(10)])
COMMENT: Is there a 10th child to check?
If Answer = 1 Then Go To Q12-164.10
| Q12-164.10 [] | Section: Fertility |
When [Name of biological child(10)] was an infant, did you BREAST FEED (him/her) at all?
| Q12-165.10 [] | Section: Fertility |
How many weeks old was [Name of biological child(10)] when you quit BREAST FEEDING (him/her) altogether?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-165A.10) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-165B.10) |
| | 0 STILL BREAST FEEDING |
| Q12-165A.10 [] | Section: Fertility |
(How many weeks old was [Name of biological child(10)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-165B.10 [] | Section: Fertility |
(How many months old was [Name of biological child(10)] when you quit BREAST FEEDING (him/her) altogether?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166.10 [] | Section: Fertility |
How many weeks old was [Name of biological child(10)] when you began feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166A.10) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166B.10) |
| | 0 FROM BIRTH |
| | 95 (DO/DID) NOT FORMULA FEED ...(Go To Q12-167.10) |
| Q12-166A.10 [] | Section: Fertility |
(How many weeks old was [Name of biological child(10)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166B.10 [] | Section: Fertility |
(How many months old was [Name of biological child(10)] when you began feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-166C.10 [] | Section: Fertility |
What are the main reasons that you chose to use formula?
(RECORD VERBATIM AND CODE ALL THAT APPLY)
| | 1 CONVENIENCE |
| | 2 NEED TO RETURN TO WORK |
| | 3 DOCTOR'S ADVICE |
| | 4 NOT INTERESTED IN BREASTFEEDING |
| | 5 HUSBAND AGAINST BREASTFEEDING |
| | 6 GOT SAMPLE FROM HOSPITAL |
| | 7 NO LACTATION CONSULTANT |
| | 8 SORE NIPPLES |
| | 9 BABY NOT GETTING ENOUGH |
| | 10 OTHER (SPECIFY) |
| Q12-166D.10 [] | Section: Fertility |
How many weeks old was [Name of biological child(10)] when you stopped feeding (him/her) FORMULA on a daily basis?
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-166E.10) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-166F.10) |
| | 0 STILL FEEDING FORMULA |
| Q12-166E.10 [] | Section: Fertility |
(How many weeks old was [Name of biological child(10)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-166F.10 [] | Section: Fertility |
(How many months old was [Name of biological child(10)] when you stopped feeding (him/her) FORMULA on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-167.10 [] | Section: Fertility |
How many weeks old was [Name of biological child(10)] when (he/she) began drinking COW'S MILK on a regular basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-167A.10) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-167B.10) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-167A.10 [] | Section: Fertility |
(How many weeks old was [Name of biological child(10)] when he/she began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-167B.10 [] | Section: Fertility |
(How many months old was [Name of biological child(10)] when (he/she) began drinking COW'S MILK on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-168.10 [] | Section: Fertility |
([Q12-164.10=1) | ([Q12-166.10=0) | ([Q12-167.10=0)
COMMENT: check if breastfeed OR formula from birth OR cows milk from birth
| | 1 CONDITION APPLIES ...(Go To Q12-169.10) |
| | 0 CONDITION DOES NOT APPLY |
| Q12-168A.10 [] | Section: Fertility |
How (was/is) [Name of biological child(10)] fed at birth?
| | 1 Intravenous feeding |
| | 2 Evaporated milk |
| | 3 Other (SPECIFY) |
| Q12-169.10 [] | Section: Fertility |
Now we would like you to think about solid food. Solid food is any food other than milk or formula, like cereal or fruit whether it is commercially prepared, like Gerbers, or prepared at home.
| Q12-169A.10 [] | Section: Fertility |
How many weeks old was [Name of biological child(10)] when (he/she) first ate SOLID FOOD on a daily basis?
(INTERVIEWER: DETERMINE WHETHER R IS ANSWERING IN WEEKS OR MONTHS OLD, AND
SELECT THE APPROPRIATE ANSWER BELOW.)
| | 1 SELECT TO ENTER NUMBER OF WEEKS OLD ...(Go To Q12-169B.10) |
| | 2 SELECT TO ENTER NUMBER OF MONTHS OLD ...(Go To Q12-169C.10) |
| | 0 FROM BIRTH |
| | 95 HAS NOT BEGUN YET |
| Q12-169B.10 [] | Section: Fertility |
(How many weeks old was [Name of biological child(10)] when he/she first ate SOLID FOOD on a regular basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF WEEKS.)
| Q12-169C.10 [] | Section: Fertility |
(How many months old was [Name of biological child(10)] when (he/she) first ate SOLID FOOD on a daily basis?)
(INTERVIEWER: R HAS ANSWERED IN NUMBER OF MONTHS. PLEASE ENTER ONLY FULL OR HALF MONTHS.)
| Q12-170 [Y02889.00] | Section: Fertility |
[[Gender of the respondent]]
COMMENT: check the gender of the respondent
If Answer = 1 Then Go To Q12-172
| Default Next: | Q12-171 |
| Lead-In: | Q12-160 [1:1], Q12-27BB [Default], Q12-30.1 [Default], Q12-161.1 [Default], Q12-161.2 [Default], Q12-161.3 [Default], Q12-161.4 [Default], Q12-161.5 [Default], Q12-161.6 [Default], Q12-161.7 [Default], Q12-161.8 [Default], Q12-161.9 [Default], Q12-161.10 [Default], Q12-169A.10 [Default], Q12-169B.10 [Default], Q12-169C.10 [Default] |
| Q12-171 [Y02890.00] | Section: Fertility |
Are you currently pregnant?
| Q12-172 [Y02891.00] | Section: Fertility |
Altogether, how many (more) children do you EXPECT to have?
(INCLUDE ANY CURRENT PREGNANCY OF RESPONDENT OR [spouse/partner])
| | 1 SELECT TO ENTER NUMBER OF CHILDREN |
| | 2 NONE ...(Go To ROS-C) |
| Q12-174 [Y02892.00] | Section: Fertility |
ENTER NUMBER OF CHILDREN:
If Answer = 0 Then Go To ROS-C
| Q12-175 [Y02893.00] | Section: Fertility |
In how many months or years do you expect to have your [first/next] child?
| | 1 SELECT TO ENTER NUMBER OF MONTHS ...(Go To Q12-175A) |
| | 0 SELECT TO ENTER NUMBER OF YEARS |
| Q12-175A [Y02894.00] | Section: Fertility |
(In how many months do you expect to have your [first/next] child?)
(ENTER NUMBER OF MONTHS:)
| Q12-175B [Y02895.00] | Section: Fertility |
(In how many years do you expect to have your [first/next] child?)
(ENTER NUMBER OF YEARS:)