The Use of Oral Contraceptives Among Finnish Teenagers from 1981 to 2003

Abstract

Purpose The teenage abortion rate has increased in Finland since 1995, after a long-term decrease. We studied changes in the use of oral contraceptives (OC) among 14–18-year-old Finnish girls from 1981 to 2003. Methods A self-administered questionnaire (the Adolescent Health and Lifestyle Survey) was sent biennially to a representative sample of 14–18-year-olds from 1981–2003. Numbers of respondents varied between 1200 and 4100 and response rates between 77% and 90%. Altogether, 35,939 girls participated. OC use, and individual, family, and place of residence factors were examined. Logistic regression models were run separately for 1981–1991 and 1993–2003. Results The proportion of OC users doubled from 1981 to 1991, from 9.5% to 19.3%. The rising trend leveled off after 1991 and settled down at around 19% to 20%. During both periods, OC use was higher among girls with early age at menarche, still in school at age 16–18 years, poor school achievement, living in one-parent families or with a stepparent, and girls whose parents had a low level of education. OC use decreased in the capital area in the early 1990s, unlike in other areas. Conclusions Adolescent OC use increased in the 1980s. A decade later, despite known increase in sexual activity, OC use remained unchanged. This was probably a result of deteriorated access to contraceptive counseling after changes in health service, and may have contributed to the increased abortion rate. Except for a decrease in OC use in the capital area, the association of individual, family, and regional factors with OC use remained mostly stable during 1981–2003.