Long-Acting Reversible Contraception Free of Charge, Method Initiation, and Abortion Rates in Finland

American Journal of Public Health
Frida GyllenbergOskari Heikinheimo

Abstract

To evaluate whether a public program providing long-acting reversible contraceptive (LARC) methods free of charge increases the LARC initiation rate and reduces the unintended pregnancy rate in the general population. Since 2013, all women in Vantaa, Finland, have been entitled to 1 LARC method free of charge. With time-series analysis between 2000 and 2015, we assessed whether this public program was associated with changes in steady-state mean rates of LARC initiation and abortions. The initiation rate of LARCs (1/1000 women) increased 2.2-fold from 1.9 to 4.2 after the intervention (P < .001). Concomitantly, the abortion rate (1/1000 women) declined by 16% from 1.1 to 0.9 in the total sample (P < .001), by 36% from 1.3 to 0.8 among those aged 15 to 19 years (P < .001), and by 14% from 2.0 to 1.7 among those aged 20 to 24 years (P = .01). The LARC program was associated with increased uptake of LARC methods and fewer abortions in the population. Public Health Implications. Entitling the population to LARC methods free of charge is an effective means to reduce the unmet need of contraception and the need for abortion, especially among women younger than 25 years.

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Citations

Nov 7, 2018·Obstetrics and Gynecology·Frida K GyllenbergOskari Heikinheimo
Oct 18, 2019·Journal of Immigrant and Minority Health·Sarah E StumbarNatalia Shringarpure
Jun 18, 2020·BMJ Sexual & Reproductive Health·Jeffrey Wale, Sam Rowlands
Oct 6, 2019·Journal of Pediatric and Adolescent Gynecology·Dan Apter
Jun 21, 2020·American Journal of Obstetrics and Gynecology·Tuire H SalorantaOskari Heikinheimo
May 15, 2021·BJOG : an International Journal of Obstetrics and Gynaecology·K Emtell IwarssonK Gemzell-Danielsson
Aug 27, 2021·Acta Obstetricia Et Gynecologica Scandinavica·Niklas EnvallHelena Kopp Kallner

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