The unequal abortion patterns in Finland

It’s been a while since my last post. A lot has happened in the last half-a-year-or-so. I became a lecturer at the University of Southampton in October, submitted my thesis to LSE in February and a couple of papers came out one of which was featured in Helsingin Sanomat (the biggest newspaper in Finland; see here in Finnish).

These last two papers that I published out of my thesis were about the association between labour market position (being employed, unemployed, student or inactive in the labour market) and the likelihood of abortion; and about the educational gradient in the likelihood of having more than one abortion. The former came out in the Finnish Yearbook of Population Research and the latter in Journal of Biosocial Science.

Both papers show that women’s socioeconomic position is associated with the likelihood of having an abortion and this has been the case since the 1970s until nowadays. Women who were unemployed were more likely to have an abortion than employed women in particular if they were not married or cohabiting. This indicates that women are concerned about the economic wellbeing of their family in an uncertain situation. During the recession of the 1990s the likelihood of abortion was higher among those who already had children and who were employed than it was before or after the recession. This implies that women may have been concerned about their position in the workplace in case they became pregnant. Given the economic situation we are facing today, it is something to consider.

When it comes to the likelihood of having more than one abortion during one’s reproductive life course, the likelihood is higher among those who have low levels of education, and the gap between the highly educated and those with no more than compulsory education has increased over time. Not many highly educated women had more than one abortion and the time since the first abortion, their relationship status or number of children they had were not associated with the likelihood. Women who had completed only compulsory education, however, had their second and third abortions sooner after the previous procedure than highly educated women and their other characteristics altered the likelihood as well. It may be that women with high education benefit more from post-abortion contraceptive counselling than women with low education.

Taken together, both of these studies show that abortion access in Finland depends on women’s standing in the society regardless of family planning provision in all municipalities since the 1970s and sexuality education in all schools. Although these are important policies and should be continued, there is a need to evaluate whether something could be done to better reach those in more precarious situations in the society.

Sources:

Väisänen, Heini (2016). “Educational inequalities in repeat abortion: A longitudinal register study in Finland 1975-2010.” Journal of Biosocial Science, doi:10.1017/S002193201600016X.

Väisänen, Heini (2015). “Labour Force Participation and the Likelihood of Abortion in Finland over Three Birth Cohorts.” Finnish Yearbook of Population Research, 50: 5-20.

How research becomes populism – Abortion debate in the Finnish Parliament

Liberal abortion legislation was introduced in Finland in 1970. Every now and then, there is discussion regarding, whether the law should be changed in any way. Some would like to see a day, when abortion is available on request (as in Sweden for instance) and others wish to make it more difficult to obtain abortions.

Recently, a few members of parliament from the Christian party, the Centre party and the True Finns party suggested that the legislation should be changed  so that medical doctors and other hospital personnel should be given a right to refuse performing abortions, if that’s against their conviction.

Last Thursday, the parliament discussed the suggestion. Quite rapidly the discussion shifted from the rights of hospital staff into whether abortions are morally justified. An MP from the True Finns party, Mika Niikko, referred to a study showing that more than 50 percent of the women, who went through a termination of pregnancy were depressed a year after the termination and that two percent suffered from severe depression. Later he tells that the study was conducted by “a researcher called Söderberg” and also mentions that there is a Finnish study by Gissler, Hemminki and Lönnqvist that found the risk of suicide being three times higher for women, who had had an abortion, compared to the women, who had a childbirth.

Given that I have worked on abortion-related topics for a while, the results of the studies seemed somewhat surprising to me and I decided to track down these papers. Since the citations are not more specific than what I’ve described above, I cannot be sure I found the right papers, but I managed to identify two, which fit the criteria (Söderberg et al.; Gissler et al.). After having looked at the results of these studies, I have to say I’m quite concerned about the relationship between academic research and policy making.

The paper by Söderberg and colleagues is a study of 854 women, who had had an abortion in Malmö, Sweden in 1989. The researchers identified a case group of 139 women that had experienced emotional distress and doubts regarding abortion decision and compared them to a control group of 114 women not having these feelings. Given that I only have access to an not-so-clearly-written abstract rather than a full text, I cannot say much about the study design, but the conclusions of the study are clear: the researchers identified risk factors of experiencing emotional distress (such as poor support from family and friends and underlying ambivalent attitude to abortion) and state “[t]he risk factors identified suggest that it may be possible to ameliorate or even prevent such distress”.

The other study compared suicides after pregnancy in Finland between 1987 and 1994. The researchers were able to identify 73 suicides within one year after the end of the 667,572 pregnancies observed during the study period. Women, whose pregnancy had ended in abortion, were six times more likely to commit a suicide than women, who had a childbirth. The researchers state clearly at the end of the paper that the study was not able to study causality between these two events, because they had no information of pre-pregnancy mental health conditions of the women. Thus, the causal relationship could go either way: suicides and abortions are caused by similar things or abortions cause mental health problems to some women. In addition, I’d bear in mind the small number of suicides observed, which adds uncertainty to any conclusions.

Had Niikko read a more recent paper from Gissler and colleagues, he would have discovered that having mental health problems is associated with a higher risk of abortion. Therefore it seems like experiencing difficult life events is associated with higher risk of abortion rather than the other way around. Also this paper ends with caution: more research is needed, before claiming causality in this complex relationship. Many previous studies have suffered from severe problems in research design and thus cannot be trusted.

So, the studies Niikko referred to were from late 1980s and early 1990s. It goes without saying that they are old and that there are more recent studies he could have referred to. Moreover, the results of the studies were clearly misinterpreted. The really sad part is that in the discussion Niikko was the only MP, who even tried to refer to academic studies to justify his point of view.

Where are the policy implications of policy relevant academic studies hiding?