Objective: The United States (US), Great Britain (GB), Sweden(S), and the Netherlands (N) have had differing degrees of success in preventing unwanted adolescent pregnancy. This report is part of a larger study comparing adolescent pregnancy prevention in these four countries. Methods: Clinicians, politicians, public health administrators, social and behavioral scientists, and anti-abortion activists (total n=75) in all four countries participated in face-to-face, semi-structured interviews. Each interview included questions regarding attitudes toward health care services for adolescents. An inductive, systematic, qualitative content analysis of verbatim transcripts of the interviews was conducted. The ages of respondents ranged from 31 to 76 years; gender breakdown was 58% female, 42% male. Results: Across all four countries, interviewees consistently described as optimal family planning services (fps) those which included easily accessible, comprehensive, multidisciplinary care provided confidentially by nonjudgmental staff. The general opinion was that communication skills and counseling were important components, as were flexible hours and proximity of services. Consensus across countries was that school nurses can provide a good entry into health care services for youth. However, differences among the countries also emerged from the data. Respondents from US and GB reported that youth lack knowledge regarding how to access fps in contrast to respondents in N and S about youth in their own countries. Pelvic examinations were perceived as a barrier to adolescent contraception in the European nations where they are either not required or delayed; in US, no interviewee mentioned the same concern. In N and S, respondents felt that youth need to pay for fps to feel responsible, whereas in US and GB, consensus was that contraception should be free for adolescents. A consistent observation was that N and S fund research, which is then used to inform public policy, whereas in GB and US, respondents noted the lack of such funding and a greater role played by politics and religion in policy decisions. Conclusion: Qualities of the fps staff and their interactions with youth was a major theme among all four countries. Respondents in N and S appeared to describe their countries' fps as closer to embodying the features identified by respondents from all four countries as characteristic of ideal fps for adolescents.