Reviewer's report 
 Women and Postfertilization Effects of Birth Control: Consistency of Beliefs, Intentions and Title: 
Reported Use 
 2  17 October 2005 Version: Date: 
 Melanie Gold Reviewer: 
Reviewer's report: 
1. Is the question posed by the authors new and well defined? Yes, the question is new and it is well
defined. The background of the paper (and the discussion) are much improved after the revisions. 
2. Are the methods appropriate and well described, and are sufficient details provided to replicate 
the work? There is now sufficient detail on the pilot-testing of the survey as well as the main study. 
The authors have added sufficient information about waivers of written and parental consent in the 
methods section. 
3. Are the data sound and well controlled? They are sound. The issue of control is not applicable to 
this survey study. 
4. Does the manuscript adhere to the relevant standards for reporting and data deposition? Yes. 
5. Are the discussion and conclusions well balanced and adequately supported by the 
data? Yes. The discussion is much improved and better balanced with the revisions. The authors did 
an excellent job addressing this reviewer’s comments. 
6. Do the title and abstract accurately convey what has been found? Yes. The title is now clearer and 
appropriately informs the reader that this is a study about consistency of responses on a survey. The 
abstract revisions now more accurately reflect the main content of the paper. 
7. Is the writing acceptable? Yes. It is written in clear English 
The authors have done a laudable job addressing the reviewer’s comments and the manuscript is 
immensely improved. There only remain a few additional comments. 
Abstract: Under methods: line 7-8, It would be more accurate if authors said “the questionnaire 
contained no information on where in the reproductive cycle methods of contraception worked” or 
“the questionnaire contained no information on the mechanism of action of different contraceptive 
methods” since this was not only limited to “no information about whether specific birth control 
methods act after fertilization”. 
Background: 1st page, 2nd paragraph, line 1-3, the author cites that “many women in national polls 
in the US believe that human life begins at fertilization.” More specific data (like a percentage or 
number) would be useful here, since the term “many” is vague. How many? 
Under Methods, Questionnaire Development, 2nd para, lines 4-6. The authors continue to lump 
together contraceptive methods (like abstinence, condoms, sterilization, natural family planning) 
with medical and surgical abortion by calling them all “methods of birth control.” I still believe this 
distinction is important to some readers and should be discussed in the text. The authors did a nice 
job of discussing this in their response to the reviewer’s comments when they said: 
“Although many people argue that surgical or medical abortion are not legitimate methods of family 
planning, others argue that abortion is an essential part of the spectrum of birth control methods that 
should be available to women. Strickly speaking, abortion is certainly a widely used method of 
reducing or controlling birth.” (some references here would strengthen the statement) 
It might help clarify this distinction to readers if the authors included something in the text like their 
above response to the reviewer since not all readers will agree with the authors’ comment that “We 
don’t think anyone will have difficulty sorting out that birth control in this table (table 2) includes both 
family planning methods as well as medical and surgical abortion”. 
It is possible that some readers will confuse medical and surgical abortion as indistinguishable from 
methods of birth control and this difference in interpretation should be discussed in the text since it is controversial. 
Under Methods, Questionnaire Development, 3rd para, lines 3. Change the word “on” to “with” in the 
sentence reading “Pilot testing of the questionnaire was performed with 21 patients…” Also, I read 
the authors’ response that the age of the pilot-test subjects is not known. This is unfortunate but cannot be fixed. However, it would be helpful for the authors to say what number or percentage of 
the 25 pilot-test subjects in Tulsa were nurses versus patients since presumably nurses might have 
a higher level of understanding of medical terms like “implantation”, compared to less educated 
patients which might influence comprehension of the survey. Also, which three questions were 
added after the pilot testing? 
Under results, end of paragraph 3, The authors might also wish to highlight in the text (because it is 
so interesting) that the birth control methods that women were most “unsure” about in terms of what 
stage they worked at were progestin-only pills, IUD and Depo-Provera (in addition to EC and natural 
family planning which is already highlighted in this section). 
Under Discussion, 2nd para, Authors should put (TPB) at the end of the words “Theory of Planned 
Behavior” in the first sentence before using the acronym TPB in the 3rd sentence. 
 Accept after minor essential revisions What next?: 
 An article of importance in its field Level of interest: 
 Acceptable Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests'