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.
PIP: This study used population register data to examine regional patterns of adolescent pregnancy and abortion in Finland's provinces during 1976-93. Since the 1970s the Finnish family planning policy has aimed to reduce unintended pregnancies through easy and ready access to contraception counseling. Provincial analysis pertained to 3-year averages during 1976-78, 1981-83, 1986-88, and 1991-93. Findings revealed that pregnancies among girls aged 15-19 years and adolescent abortions declined during 1975-93. The variation in pregnancy rates between provinces, however, remained the same. In 1993, the fertility rate was 10.5, the abortion rate (per 100 live births) was 9.5, and there were 20 pregnancies per 1000 girls. During 1976-78 there were 34-58 pregnancies per 1000 girls. The abortion rate ranged from 14 to 25 in 1993. The abortion rate was highest in Lapland and the capital province of Uusimaa. 8 out of 11 provinces showed similar patterns of decline in adolescent pregnancy and abortion. Pregnancy rates showed less of a decline in Uusimaa and North Karelia. The highest pregnancy rates were in North Karelia and Lapland. Among girls aged 16-17 years, the pregnancy rate declined the most in Oulu and Vaasa. The pregnancy rate decreased sharply in Vaasa. The abortion rate remained the lowest in Oulu and the highest in Uusimaa. The abortion rate in Karelia declined by only 23%. During the study period, induced abortion was more frequent than childbirths in all provinces among young adolescents. In 1993, the abortion rate ranged from 7 to 10 among young adolescents, except in Lapland and Uusimaa, which had higher rates. The fertility rate among young adolescents was 4-8 in all provinces in 1991-93. Older adolescent childbirths and abortions varied in the early 1990s between southern and northern provinces. Pregnancies and childbirths at age 18-19 years were higher in peripheral regions than in southern Finland.