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. 2014 May 29:14:523.
doi: 10.1186/1471-2458-14-523.

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden

Adam Sydsjö, Gunilla Sydsjö, Marie Bladh, Ann Josefsson  1
Affiliations

Reimbursement of hormonal contraceptives and the frequency of induced abortion among teenagers in Sweden

Adam Sydsjö et al. BMC Public Health. .

Abstract

Background: Reduction in costs of hormonal contraceptives is often proposed to reduce rates of induced abortion among young women. This study investigates the relationship between rates of induced abortion and reimbursement of dispensed hormonal contraceptives among young women in Sweden. Comparisons are made with the Nordic countries Finland, Norway and Denmark.

Methods: Official statistics on induced abortion and numbers of prescribed and dispensed hormonal contraceptives presented as "Defined Daily Dose/thousand women" (DDD/T) aged 15-19 years were compiled and related to levels of reimbursement in all Swedish counties by using public official data. The Swedish numbers of induced abortion were compared to those of Finland, Norway and Denmark. The main outcome measure was rates of induced abortion and DDD/T.

Results: No correlation was observed between rates of abortion and reimbursement among Swedish counties. Nor was any correlation found between sales of hormonal contraceptives and the rates of abortion. In a Nordic perspective, Finland and Denmark, which have no reimbursement at all, and Norway all have lower rates of induced abortion than Sweden.

Conclusions: Reimbursement does not seem to be enough in order to reduce rates of induced abortion. Evidently, other factors such as attitudes, education, religion, tradition or cultural differences in each of Swedish counties as well as in the Nordic countries may be of importance. A more innovative approach is needed in order to facilitate safe sex and to protect young women from unwanted pregnancies.

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Figures

Figure 1
Figure 1
Induced abortion in all Swedish counties in relation to DDD/T in 2010.
Figure 2
Figure 2
Hormonal contraceptives presented as DDD/T in eight counties with the same subventions 2000-2010.
Figure 3
Figure 3
Induced abortion in the same counties as in Figure 2, 2000-2010.
Figure 4
Figure 4
Sales of G0A3 expressed in DDD/T in eight counties, Skane and Blekinge reimburse all costs. Vasterbotten does not reimburse at all. The other 5 counties reimburse to some extent.
Figure 5
Figure 5
Differences in induced abortion in the same eight counties as in Figure 4.
Figure 6
Figure 6
Induced abortion and dispensed hormonal contraceptives 2000-2010 in all counties in Sweden.
Figure 7
Figure 7
Induced abortion among women 15-19 years in Nordic countries 2000-2009.
See this image and copyright information in PMC

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