The changing pattern of contraceptive use and pregnancies in four generations of young women

Abstract

Introduction: The aim of this study was to describe contraceptive use and pregnancies and their relationship to socio-economic status (SES) in four generations of young Swedish women. Material and methods: Questionnaires regarding contraceptive use and pregnancies were sent to random samples of 19-year-old women in 1981, 1991, 2001 and 2011 (n = 4732). Results: Current contraceptive use was higher in 2001 (78%) (p < 0.01) and 2011 (69%) (p < 0.05) compared with 1981 (60%) and 1991 (62%). Combined hormonal contraception (CHC) was the most common form of contraception throughout (p < 0.0001). The use of long-acting reversible contraception (LARC = implants, intrauterine contraception) and progestogen-only pills increased over time (p < 0.01). Mental side effects as a reason for CHC cessation increased over time and was the most common reason for cessation of CHC in 2011 (p < 0.001). Contraceptive use was lower in women from low SES areas (p < 0.05) in 2011. The percentage of young women who had been pregnant at ≤19 years of age was lower (p < 0.05) in the assessment from 2001 (7%) than in that in 1991 (13%) and 2011 (12%). The proportion of teenage mothers decreased from 4.4% (1981) to 1.6% (2011) (p < 0.01). More women had been pregnant at ≤19 years of age in low SES areas than in middle and high SES areas (p < 0.05). Conclusions: The lowest pregnancy rate was in the cohort with the highest contraceptive use. Term pregnancies declined over time. A greater number of pregnancies in low SES areas and a change towards lower contraceptive use in low SES areas was recorded in 2011.