Reduced number of abortions. Result of easily accessible and good quality contraception counseling and inexpensive oral contraceptives

The community of Solna Sweden with a population of 55000 had one of the highest abortion rates among young women in 1989: 50/1000 women 15-25-29 years old. Among the causative factors were the diminished access to counseling and articles about the possible risks of oral contraceptives had created a negative perception of them. Therefore a project group was organized to improve counseling access to contraceptives and information about contraception. This consisted of representatives of the primary care district the womens clinic of Karolinska hospital and an AIDS prevention organization. The project started in November 1990 and lasted for 2 years. Educational input consisted of reading sessions where the primary care personnel the community youth agency and school health ward were invited. In addition at a womens clinic staffed by a gynecologist and nurses counseling about contraceptives and subsidized oral contraceptive prescriptions were provided. A youth group was formed to learn about contraception abortion and sexually transmitted diseases. In 1990 roughly 1300 visits occurred for counseling at the Solna clinic. This increased by 56% as a result of the project. Furthermore prescriptions and counseling by telephone doubled. In 1989 among visitors under 23 years old 60% were OC users. By 1991 this figure increased to 81% (p < 0.001). A 1992 survey evaluated this project enlisting 200 respondents. 75% of those 23 or older said they had learned about it via the telephone help-line. All young women approved of the free OCs and 97% thought more women would use them if they were free of charge. During this period in Solna abortions decreased by 30% in the municipality of Stockholm by 19% and in Sweden by 20%. In the age group of 25-29 in Solna abortions dropped by 28% vs. by 14% in Stockholm and by 4% in Sweden. The subsidy of OCs continued for women under 23 years old.