How to Tackle the Socioeconomic Inequalities of Teenage Pregnancy

In the media, Finland is often displayed as an example of a country where society has taken big steps in ensuring equality in children’s upbringing: the world’s leading education system is free, parents are well supported financially, and able to choose between a long parental leave and working full time. At the same time their children are taken care of in one of the many public nurseries with university educated kindergarten teachers and parents only have to pay a small fraction of the costs.

When adolescents reach their teens and begin to explore elements of the adult world such as sex, it is important to ensure that they are equipped with enough information regarding sexual health, contraception and the emotions involved. Apart from a few recession years in the 1990s, sex education has been a compulsory part of the curriculum in Finland since 1970¹. That, among other reasons, has resulted in internationally low teenage pregnancy rates despite a temporary increase in the late 1990s^2,3. In addition, contraceptives have been easily available from a variety of sources including school health centres and the public healthcare system since the early 1970s⁴.

Studies in the US and UK^5,6 have found that teens who lack the possibility of pursuing certain careers, may wish to start childbearing at a young age because they see that as a legitimate pathway to adulthood. Perhaps the low teen pregnancy rates in Finland indicate that the policies mentioned above have been successful in providing alternative pathways to adulthood, making the remaining teen pregnancies happen due to other reasons than one’s socioeconomic position?

Although I do think that these policies are needed and should continue, it looks like they have not been very successful in decreasing the socioeconomic gap in teenage childbearing and abortions. Evidence for this is based on the results of our study looking at fertility behaviour of three birth cohorts of Finnish women when they were aged 15 to 19 (born in 1955-59, 1965-69 and 1975-79).

The likelihood of teenage childbearing or abortion was the highest for the adolescents from low socioeconomic status households, in particular if the head of the household was a manual worker. Among the teenagers who experienced a pregnancy the odds of choosing an abortion rather than childbearing were two to three times higher for teens from white-collar backgrounds, indicating a will to postpone childbearing – perhaps in order to pursue higher education and a career.

Interestingly, the socioeconomic differences were the largest for the 1960s cohort, even though they were the ones who should have enjoyed the best family planning services and sex education. The 1950s cohort was already in their teens when sex education and family planning services became compulsory in all municipalities, whereas the 1970s cohort suffered from cuts in these services due to the severe recession in the 1990s.

The results of the study do not claim that teens are better off without sex education and family planning services – in fact teen pregnancy rates started to increase soon after cuts were made to these services and started to decline again after the services were re-introduced. However, there is a need for tailored policies taking into account the different backgrounds of the adolescents. Although targeted family planning services and sex education should be in the core of these policies, it is equally important to provide support for teens who conceive regardless of whether they decide to carry the pregnancy to term. All adolescents, irrespective of their pregnancy history should be able to attend school and pursue the career of their choice.

References

1. Kontula, O. The evolution of sex education and students’ sexual knowledge in Finland in the 2000s. Sex Educ. 10, 373–386 (2010).
2. Heino, A. & Gissler, M. Induced abortions 2011. (National Institute for Health and Welfare, 2012).
3. Vuori, A. & Gissler, M. Perinatal statistics: parturients, deliveries and newborns 2012. (National Institute for Health and Welfare, 2013).
4. Kosunen, E. in New Views Sex. Health – Case Finl. (Lottes, I. & Kontula, O.) 70–84 (Väestöliitto, 2000).
5. Hayford, S. R. & Guzzo, K. B. Racial and Ethnic Variation in Unmarried Young Adults’ Motivation to Avoid Pregnancy. Perspect. Sex. Reprod. Health 45, 41–51 (2013).
6. Smith, D. M. & Roberts, R. Social inequality and young pregnancy: the causal attributions of young parents in London, UK. Health Place 17, 1054–1060 (2011).