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Free contraception causes big drop in youth abortion and STDs

Four years ago, the southwest Finnish city of Rauma noted that abortion rates among its young people were rising and made a decision to offer contraception to its residents under 20 for free. Since that time, the number of abortions in Rauma has dropped by over 50 percent and incidence of the sexually-transmitted disease (STD) chlamydia has fallen by 30 percent.

Kaksi tyttöä ehkäisyneuvolassa.
Midwife Titta Taivainen works at the Rauma contraception clinic. Image: Dmitri Volgin / Yle

For years now, Finland’s Ministry of Social Affairs has joined the National Institute for Health and Welfare (THL) in recommending that municipalities should offer young people free contraception. For the time being however, only a few localities in Finland have chosen do so. More may soon follow suit, however, as figures from the southwest city of Rauma show a marked drop in expensive abortions and treatment for sexually-transmitted diseases after its decision to offer young people contraception free of charge.

Rauma began to offer free contraception to girls under the age of 20 four years ago. The decision to provide the free service stemmed from a local citizen’s initiative, as the numbers of teenage pregnancies and abortions in the mid-sized coastal city had been on the rise. Young people in the area welcomed the move.  

“I think it is great that we don’t have to pay. The cost can be a threshold for many young people: do I dare to or want to ask my parents for money. For many, it is hard to even broach the subject,” says high school student Selma Laaksonen.

Free contraception saves money

The city of Rauma incurs a cost of around twenty thousand euros per year to finance free contraception, in practice oral contraception pills, for young people. Rauma’s family centre director Anne Vertainen has calculated that this investment saves the municipality up to 100,000 euros each year on reduced abortions, as abortion procedure costs in Rauma run upwards of 2000 euros.

“The free pill has caused a dramatic drop in the number of abortions for girls under 20. Still in 2011 we recorded 71 abortions in this area, whereas last year the number had dropped to 40,” says Vertainen.

About 200 new youth start taking contraception each year, when all area children in the eighth grade are informed about the free option. Some younger children begin taking the pill even earlier.

“Our youngest clients are 13 years old,” says midwife Titta Taivainen, who works at the Rauma family centre’s contraception clinic.

Taivainen says that all customers of the clinic are treated confidentially, even if they are minors. Nothing is reported to the children’s homes, and no attempt is made to dissuade the girls from starting the pill.

“If they feel they have a need for contraception, it is without a doubt a good thing that they come to us,” says Taivainen.

No cost means wider use

Finland’s Ministry of Social Affairs and Health has long recommended that Finnish municipalities provide contraception to its young residents free of charge. This would reduce the number of sexually-transmitted diseases among young people and prevent unwanted pregnancies and abortions, the Ministry reasons.

Over 1,600 abortions were performed in Finland in 2014 on women under twenty. Even though the decision in Rauma to offer free contraception has produced good results, few other municipalities have followed suit. Yle is only aware of two other municipalities in Finland offering free contraception to young people: the south-central city of Forssa and the Lapland city of Tervola.  

Young Selma Laaksonen says she believes that making contraception free encourages more young people to use it.

“Contraception would surely be used more widely if it was free. Not everyone is prepared to spend money on that sort of thing,” she says.

The free contraception programme extended to young people in Rauma also distributes free condoms, in addition to the pill. Chlamydia infections among Rauma youth are down by one-third as a result. In 2011 there were 110 chlamydia cases among Rauma youth, but in 2014, the number had dropped to 77.

“Condoms are handed out to our young customers on an at-need basis. They are not intended for regular use,” says Rauma’s family centre director Vertainen.

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