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Leena Ruusuvaara M.D., Ph.D. Finland. Same goal. Healthy young Adults Children. Different approach guided by religion, culture, tradition and economy. Reproductive and sexual health includes. The right to your own body Knowledge and education

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Presentation Transcript
same goal
Same goal

Healthy young



Different approach

guided by religion, culture, tradition

and economy

reproductive and sexual health includes
Reproductive and sexual health includes
  • The right to your own body
  • Knowledge and education
  • To have the opportunity to prevent unwanted pregnancies and STD´s
ways to reproductive health
Ways to reproductive health
  • Knowledge
  • Services
  • Non-judgemental environment
succesful approaches to contraceptive counseling
Succesful approaches to contraceptive counseling
  • Easy acces (i.e. Youth clinics, shool-nurse)
  • Low cost or free of charge condoms and oral contraceptives (OC´s)
  • Down to earth information of sexually transmitted diseases (STD:s)
  • Support when needed psychological
succesful approaches to safe sex
Succesful approaches to safe sex
  • Open attitude to sexual matters with emphasis on – responsibility
  • Balanced sex – education with emphasis on –responsibility
  • Contraceptive councelling with emphasis on motivation – and responsibility
70% of 18 year olds are sexually active
  • One cannot afford to ignore the needs of sexually active teenagers

Advocates for youth

Our main goal (as parents, politicians and health care personnal) shoud be:

”Helping young people make safe and responsible decisions about sex”





approach U.S.

Just do it

Just say NO

about contraceptive practice
About contraceptive practice
  • After a young man or a woman has accepted his or hers sexuality, it is much easier to cope with prevention
  • You are using contraception not only to avoid becoming pregnant, but because you would like to have sex
reproductive health
Reproductive health


reproduction relationships

therapy communication

medical control own ”control” = responsibility

technical language colloquial language

preventive measures preventive behaviour

  • Early sex-education would encourage early sexual experimentation

NO – this is not supported by the relevant litterature or experiences from countries where sex-education is available

  • If ”morning after pill” is easily available, it would cause non-use of other contraceptives

NO – the available data shows that a number of unwanted pregnancies and abortions are avoided – and the girl seeks for contraceptive advice

  • Young boys are lousy condom-users

NO – the literature shows that increasing amount of teenagers rely on condom as their preventive method both against STD´s and pregnancy

  • Abortion on demand would cause increasing numbers of abortions

NO – in countries where (legal) abortion is on demand together with family planning services, the number of abortions (and STD´s) are lowest

The number of abortions

does NOT tell the number of unwanted pregnancies

The percentage of unwanted pregnancies that are terminated by abortion is influenced by many factors
  • The culture of the area
  • Its religious make up
  • The availability of emergency contraception
psychosomatic prevention of sexual risk behavior
Psychosomatic prevention of (sexual) risk behavior
  • Learn to identify those at risk
  • Depressive behaviour
  • Even relatively short psychiatric intervention can have great impact
physicians for reproductive choice and health
Physicians for reproductive choice and health
  • Declining pregnancy rates among teens is primarily due to better contraceptive use, and secondarily due tu lower rates of sexual intercourse

(Darroch and Singh)



Sex education

Social situation

(cultural, religion etc.)


Sex education

Social situation

Yes, I am ready

I can do it

No, it is not the

right time, yet

some reasons for scandinavian countries having low teen pregnancy and abortion rates
Some reasons for Scandinavian countries having low teen pregnancy and abortion rates
  • School education for all
  • Sex education at schools for decades (in Sweden nearly 50 years)
  • Sex is not a tabu
  • Genders are equal
  • Abortion and demand – contraception counseling is free
Abortions in Finland

< 20 years of age14.8/ 1000

Stakes 2005

Abortions in U.S.A.

< 20 years of age20/ 1000

Advocates for youth, 2002

history and development
History and development
  • Borlänge 1970
  • Gustav HögbergChild and adolescent physician
  • Idea: combine matters relating to body and soul and to integrate these with sex education and matters relating to interpersional relationship
  • Abortion legislation 1975
health on equal terms swedish government committee report sou 2000 91
Health on equal termsSwedish Government Committee Report SOU 2000:91

”There are strong arguments for inputs at an early state from the social, humanist, medical and econimic perspectives. Reinforced health promotion and preventive measures with the focus on mental health contains a considerable potential for societal and econimic savings.”

objective 11 national objectives for public health
Objective 11”national objectives for public health”

”Preventing health risks associated with sexual behaviour is primarily about strengthening the individual´s identity and self-respect”

Method of work:

Health promotion and preventive work






Pregnancy rate

(birth & abortion)


Scandinavian Countries








Adapted from into a New World,

The Alan Cuttmacher Institute, May 1998

  • School personnel need support
  • Parents need support
  • Grown-ups need up-to-date information
casual sex
Casual sex
  • No contraception
  • No consequences
  • And – often –

no deeper feeling for each other

prolonged adolescence
Prolonged adolescence
  • Young people do not move out
  • They can have their girlfriend / boyfriend overnight at their parent´s house
  • They can ”empty the refrigerator”
  • They use their own money for FUN
  • They skip the adult responsipility
”I dream of the day when all children born are welcome, all men and women are equal and sexuality is an expression of intimity, caressing and enjoyment.”

Elise Ottensen Jensen (1886-1973)

One of the first women who lectured about reproductive health