Free hormonal contraception halved termination rate, Norwegian study finds

The project came to an end in December 2009, and the results obtained by the SINTEF Technology and Society scientists were quite clear:

The abortion rate in the trial cities was halved, and the women involved were very happy to be given free contraception of this sort, according to the project manager, research manager Anita Øren.

Abortion rate rising

In 2002, Norwegian women aged between 16 and 19 were offered free hormone-based contraception. Abortion rates fell dramatically and reached their lowest level in 2005. In 2006, after the authorities modified the scheme and introduced part-payment for hormonal contraception, the number of terminations among this age-group began to rise once more. Since then, the abortion rate among 16- to 19-year-olds has risen every year.

Women aged 20 to 24 have the highest number of abortions, and this rate has risen steadily in the course of the past few years. The study demonstrates that when women in this age-group are offered gratis contraception, their abortion rate also falls.

More continuous use

The results demonstrate that Norwegian women are efficient users of contraception. No fewer than 93 percent of them say that they have used hormonal contraception in the course of their lives.

The study also shows that the actual number of women using hormonal contraception tended not to increase in the course of the study. However, the women in the trial municipalities who were offered gratis contraception used with fewer breaks in use.

The women in the study claimed that an important reason for their continuous use was that the hormonal contraception was free They themselves said that they tend to leave of contraception when they are less well-off," says Øren. The researchers also looked at how the contraceptives were picked up from chemists', both before and during the study period. The figure clearly showed that users picked up their contraception more often during the period when it was free.

"The offer of free hormonal contraception doe not necessarily lead to more users, but to more frequent use," says Øren. If the aim is to reduce the number of terminations, the project shows that the offer of free hormonal contraception can be an effective measure. It is also what women themselves say that they want," she adds.

Twice as much use of long-term methods of contraception

In the cities involved in the trial, the use of long-term methods of contraception such as hormonal spirals and IUDs/implants more than doubled. These methods work continuously for three to five years and provide the best protection against undesired pregnancy. As a one-off investment, however, they are regarded as more expensive alternatives to the "Pill."

"Women themselves say that they are very pleased to have the freedom to choose the type of product they prefer, irrespective of price," says Øren.

About the contraceptive study

• The cities covered by the trial were Tromsø and Hamar, while the control cities were Bodø and Porsgrunn.
• Women from 20 -- 24 years of age were offered free contraception between May 2008 and May 2009.
• A questionnaire was distributed to 20- to 24-year-old women, both before the start of the trial and after it had finished.
• The methods of contraception covered by the offer included contraceptive pills, mini-pills, contraceptive injections, skin patches, vaginal rings, IUDs, implants, hormone spirals and copper spirals.
• Women aged between 20 and 24 have the highest rate of abortions in Norway.
• The project was carried out on behalf of the Directorate of Health.