The changing pattern of contraceptive use and pregnancies in four generations of young women.

Abstract

The aim of this study was to describe contraceptive use and pregnancies and their relationship to socio-economic status (SES) in four generations of young Swedish women. Questionnaires regarding contraceptive use and pregnancies were sent to random samples of 19-year-old women in 1981, 1991, 2001 and 2011 (n=4732). Current contraceptive use was higher in 2001 (78%) (p<0.01) and 2011 (69%) (p<0.05) compared with 1981 (60%) and 1991 (62%). Combined hormonal contraception (CHC) was the most common form of contraception throughout (p<0.0001). The use of long-acting reversible contraception (LARC=implants, intrauterine contraception) and progestogen-only pills increased over time (p<0.01). Mental side effects as a reason for CHC cessation increased over time and was the most common reason for cessation of CHC in 2011 (p<0.001). Contraceptive use was lower in women from low SES areas (p<0.05) in 2011. The percentage of young women who had been pregnant at ≤19years of age was lower (p<0.05) in the assessment from 2001 (7%) than in that in 1991 (13%) and 2011 (12%). The proportion of teenage mothers decreased from 4.4% (1981) to 1.6% (2011) (p<0.01). More women had been pregnant at ≤19years of age in low SES areas than in middle and high SES areas (p<0.05). The lowest pregnancy rate was in the cohort with the highest contraceptive use. Term pregnancies declined over time. A greater number of pregnancies in low SES areas and a change towards lower contraceptive use in low SES areas was recorded in 2011.