Family Planning in Sweden

This fact sheet explores attitudes in Sweden toward sexuality and childbirth from a historical perspective. After describing the strict social control over abortion and contraception in place 100 years ago, and the gradual easing of those controls in response to the low birth rate, the paper goes on to discuss the 1974 Abortion Act, which legalized abortions, and the 1976 Sterilization Act. Next, the fact sheet examines the National Family Planning Program, which initiated three important activities: (1) sex education in schools and public information about sexuality and personal relations; (2) expansion of contraceptive services and family planning services within the public health systems; and (3) access to safe, legal abortions). The final sections of the fact sheet evaluate the effects of legalized abortion and abortion prevention work, noting that contraceptive services are easily accessible and free of charge in the health services, a woman wanting an abortion may consult a social worker, and most abortions are performed at an early stage of pregnancy. (AP) *********************************************************************** * Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** Family Planning in Sweden Attitudes in Sweden towards sexuality, birth control and childbirth have changed radically over the last hundred years. Women's reproductive health has improved, as has the ability of women and men to plan their families. important social reforms behind this development are sex education in schools, public information about sexuality and personal relations, legislation on abortion, sterilization and birth control, as well as comprehensive ante-natal and family planning services integrated into the public health system. Historical perspective A hundred years ago, social control over sexuality and childbearing was strict in Swedish society. A law from 1910 banned all information about and sales of contraceptives. Abortion was a crime which could lead to imprisonment for the woman and her accomplice. Despite a very limited access to contraceptives a rapid demographic change took place at the beginning of the 20th century. The total fertility rate dropped from four children per woman in 1900 to 1.7 in the mid1930s. Information about the contraceptive methods of the day, the condom and the diaphragm, was disseminated by individual popular educators and non-governmental organisations. People used traditional practices, such a. coitus interruptus, lengthy breast feeding and periods of abstention. There were also considerable numbers of illegal abortions. In the 1930s. partly as a reaction to the low birth rate, a number of social reforms were introduced. These included universal antenatal and child care. The ban on contraceptives was lifted and birth control services were gradually introduced in ante-natal clinics, both after childbirth and for childless women. Sex education was introduced into the school curriculum in 1942. Sex education focused initially on biological facts about reproduction and how to protect oneself against unwanted pregnancies and venereal diseases. Only sexual relations within marriage were condoned. The absolute ban on abortions was lifted in 1938 by a law which permitted abortion on medical, humanitarian and eugenic grounds. In 1946 a social medicine indication was added, and a further addition in 1963 allowed for abortion in the case of possible foetal damage. Permission for an abortion was granted by the then National Medical Board (now National Board of Health and Welfare, Socialstyrelsen) after meticulous investigation. It was also possible to obtain an abortion with the consent of two doctors: a psychiatrist and a gynaecologist. In the 1950s, abortions were chiefly granted to women with somatic or mental illnesses or those who already had a large family. Sometimes permission was given on the condition that the woman was sterilized at the Births and abortions, 1975-1993 same time. Such forced sterilizations continued until the 1960s. In the period 1930-1960, between 3,000 and 6,000 legal abortions were performed each year, while the annual number of illegal abortions was estimated at 15,000-20,000. Illegally induced abortions were particularly common among young women, and complications arising from these illegal practices caused many deaths. Social attitudes changed in the 1960s and sexual freedom grew, but the abortion law was still strictly applied. Many women went abroad (to Poland) or paid privately for an abortion. Many young women who could not pay turned to backstreet abortionists. Women's groups and activists protested against women having to endanger their health and a lively public debate ensued. In 1965, a government commission was charged with the task of liberalizing the abortion law. The old law was being applied increasingly liberally and the number of legal abortions rose year by year. The increase in teenage abortions in the first half of the 1970s was a new phenomenon. In 1970, 16,000 abortions were carried out. Eventually, the number of illegal abortions fell and, as far as is known, no illegal abortions have been carried out in Sweden since the end of the 1960s. In 1974, Parliament approved a new Abortion Act, making abortion free on request. The number of legal abortions that year was 30,600. Birth control legislation in the 1970s In addition to the Abortion Act, Parliament granted SEK 1 million per year for five years to the National Board of Health and Welfare for a long-term health education programme imed at preventing unwanted pregnancies. Further money was allocated to women's groups, youth groups and immigrant organisations for contraception information. State grants were allocated to contraceptive services. 1974 also saw a new law on free services and contraceptives at subsidized prices.