The European Society of Contraception and Reproductive Health (ESC) supports free and informed choice of contraception for women and men of all ages but especially for young people
Brussels, 26 September 2021 – “In Georgia and other countries in our region, young people face serious barriers to accessing life-saving family planning services, including insufficient knowledge about modern methods and healthcare providers who discourage the use of contraception among unmarried people. Therefore, many young couples aged 17–24, become pregnant before they are ready. Social norms also limit girls’ status and restrict decision-making power.” Says Dr Lela Shengelia ESC Board member for Georgia
“I Choose”, the WCD banner for this year calls on providers and decision makers to rally to empower young people to make free informed choices.
Trends in teenage pregnancies: country case from Estonia
The teenage abortion rate in Estonia in 2019 – 8.4 per 1000 teenagers – is in the same range as the one reported in the neighbouring Nordic countries, which are globally well-known for their excellent reproductive and sexual health indicators. A recent major global overview of trends in teenage pregnancies from the mid-1990s until 2011 showed that the steepest annual percentage decline (4%) took place in Estonia. The decline has continued since then.
Doctor Kai Haldre, member of the European Society of Contraception and Reproductive Health Educational Group explains the background of this remarkable development: “After regaining independence in 1991, following almost 50 years of Soviet occupation, Estonia has undergone major socio-economic changes including profound educational and health care reforms. Reliable systems for the collection of health statistics were established and Estonia joined the European Union in 2004.
Mandatory comprehensive sexuality education lessons were introduced to the school curriculum in 1996 and a network of youth-friendly sexual and reproductive health services has been developed over the last 25 years, resulting in the establishment of 18 centres by 2021. According to a study by UNFPA from 2011, in Estonia, sexuality education in schools and easy access to services for young people have also proven to be cost-effective. The example from Estonia, during the last 30 years, demonstrates that a substantial decrease in teenage abortion rates occurs in the context of legal and safe abortion, liberal legislation, easy access to contraception, youth-friendly services and mandatory holistic sexuality education lessons in schools. Availability of choices and education about them seem to enable young people to make healthy choices for themselves. Additionally, the last survey, in 2015, showed that the proportion of 15-year-olds and younger teens who reported sexual intercourse had decreased to 15% having previously been 20–22% by similar study reports starting in 2003. The investigation of country-specific teenage pregnancy trends – both abortions and deliveries – might serve as a reference to enable decision-makers to find the best strategies for the local prevention of unintended adolescent pregnancies.”
2 Educational resources for health care providers
- An open access paper from WHO on “Adolescent health”
Improving access to and use of contraception by adolescents: What progress has been made, what lessons have been learnt, and what are the implications for action?
Venkatraman Chandra-Mouli, Elsie Akwara, Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 66, 2020, Pages 107-118, ISSN 1521-6934,
- A free access slide deck by Kai Haldre, Estonia on “Adolescent sexual health”
These slides were presented at our ESC Seminar in May 2021 with links to WHO documents.