Towards regional equality in family planning: teenage pregnancies and abortions in Finland from 1976 to 1993

Background. A major goal of Finnish family planning policy since the 1970s has been to minimize unintended pregnancies by providing equal contraception and abortion services throughout the country. This report looks at how this policy has succeeded among teenagers. Methods. The data on childbirths, induced abortions and mean populations were collected from the national abortion and population registers. Regional and age-specific rates were calculated for fertility, abortions and pregnancies in girls aged 15-19. Results. In 1993, the teenage pregnancy rate was 20/1000 and the abortion rate 9.5/1000 in the whole country. Although the pregnancy rate had dropped by half since the 1970s, the regional differences were still there: the lowest rate was 18/1000 and the highest 29/1000 (in Lapland) in 1991-93. The abortion rate ranged from 8/1000 to 14/1000. Childbirths decreased, particularly at the beginning of the study period, while abortions declined sharply towards the end of the period. In 1986-88, the abortion ratio exceeded 100 in all provinces except two. In the 1990s, it dropped below 100 again except in the capital province. In 16-17 year-olds, the trends were quite equal in different provinces. In 18-19 year-olds, pregnancies remained more frequent in the north and were more often carried to term, while the choice of abortion was more likely in the south. Conclusions. Equally declining trends in pregnancies in all provinces suggest that teenage family planning services have a comprehensive coverage. However, regional differences still remain and imply a detailed analysis of their reasons.