The use of oral contraceptives among Finnish teenagers from 1981 to 2003.

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.