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$Unique_ID{COW03467}
$Pretitle{441}
$Title{Sweden
Family Planning in Sweden}
$Subtitle{}
$Author{Swedish Institute}
$Affiliation{Swedish Embassy, Washington DC}
$Subject{abortion
abortions
act
health
information
week
women
family
planning
number}
$Date{1990}
$Log{}
Country: Sweden
Book: Fact Sheets on Sweden
Author: Swedish Institute
Affiliation: Swedish Embassy, Washington DC
Date: 1990
Family Planning in Sweden
Sweden's current legislation in the field of family planning dates from
the mid-1970s and includes the Abortion Act and the Sterilization Act. At the
same time as these laws were passed it was decided that greater resources
would be devoted to preventive family planning measures. One purpose is to
reduce the number of abortions.
The main idea behind the legislation is that the individual has the right
to decide freely on the number and spacing of children. This also means that
every child has the right to be wanted. It is understood that this goal is to
be reached through preventive measures and that free abortion is a complement
to these-an emergency measure. To this end efforts have been made in three
areas: family planning services, reducing the cost of contraception to the
individual, and information on planned parenthood.
The family planning program
Up until 1985, the Government provided county councils and other
organizations with financial support for the expansion of family planning
services. Nowadays, county councils receive a certain sum per inhabitant for
preventive measures in general. This means that the county councils themselves
decide how the money is to be used.
There is a provision to the effect that the consultation must be free of
charge to the person seeking advice and that contraceptives to some extent be
dispensed free of charge. Diaphragms or IUD's inserted during the consultation
are free. Condoms and spermicides may also be dispensed during the course of
such consultations. Oral contraceptives are sold at a subsidized cost.
A system of family planning services integrated with the maternity health
care system has been built up. Free counseling is available at maternity
clinics, at district physicians' surgeries, through private doctors or at two
clinics operated by the Swedish Association for Sexual Information (RFSU).
There are also about 130 youth clinics where young people can obtain advice on
different methods of birth control. To some extent, teenagers can also receive
advice from school physicians or nurses.
To widen the scope of family planning services and to make them more
easily available, midwives are trained to give advice about contraceptives.
Since 1980, 70% of the public health consultations given each year regarding
contraception have been performed by midwives.
To increase information on family planning, the National Board of Health
and Welfare (Socialstyrelsen) has been working on a long-term information
program on family planning. This has been financed with grants from the
Government. Money has also been allocated for information via youth and
women's organizations.
Encouraging experiences, in terms of a decreased abortion rate,
especially among teenagers, better doctor-patient, teacher-pupil and
parent-child relations were reported from a comprehensive information program
on the island of Gotland at the end of the 1970s. Services in family planning
there were combined with the training and education of all categories of
social, health and school personnel and with information activities to involve
the public. The positive results of the project on Gotland have led to similar
information campaigns in other parts of Sweden.
The Abortion Act
The Abortion Act went into force in 1975. The main principle contained in
this Act is that the woman herself decides if an abortion is to be carried
out. The Act specifies as follows:
- Abortion is free upon request up to the end of the 18th week of
pregnancy.
- Before the 12th week, the woman need only consult a doctor. After the
12th week she is required to discuss the matter with a social worker as well.
The woman may be refused an abortion only if the operation involves a risk to
her life or health.
- After the end of the 18th week of pregnancy, the approval of the
National Board of Health and Welfare is necessary to obtain an abortion, and
there must be special reasons for the permission. Such approval may not be
granted if the foetus is judged to be viable.
The Act applies in principle only to women who are Swedish citizens, or
resident in the country. In special circumstances, however, the National Board
of Health and Welfare can give permission for an abortion to a foreign
national not residing in Sweden.
Only a qualified medical practitioner may perform an abortion, and the
operation must take place at a hospital or other medical institution approved
by the National Board of Health and Welfare.
Enforcement of the Act
The Act was designed to simplify procedures and to ensure that abortions
are performed early during pregnancy.
The contact with a social worker is intended to give the woman help and
support in a difficult situation. In principle, it is compulsory after the
12th week.
If the woman herself needs support to make her decision, she can of
course request an appointment with a social worker, as well as with a
psychiatrist or other adviser. This abortion counseling is voluntary and free
of charge, and it should always be offered when a woman contacts a hospital
because she is considering an abortion. The advisory service should not be
aimed at influencing her decision in one direction or the other, but the
adviser should help her arrive at a decision she feels is right for her. The
woman is welcome to bring the prospective father, or some other person she
trusts, along to her appointment with the social worker. Contacts with
relatives and other people should, however, be made only in the woman's own
interest and only with her approval.
To avoid abortions at a time when the foetus may be presumed to be
viable, and keeping in mind the increased risk of complications involved in
late abortions, a special limit has been set at the 18th week of pregnancy.
From then on, permission for abortion can only be given by the National Board
of Health and Welfare, and then only if there are particularly strong reasons
for such a step.
The National Board of Health and Welfare usually does not grant
permission after the 22nd week. In exceptional cases, abortions can be
permitted until the 24th week. The only departure from this rule is the
emergency situation arising when the woman's life or health is at serious
risk.
When an abortion is performed prior to the end of the 12th week of
pregnancy, it is usually performed by vacuum aspiration. Normally, the woman
need not be hospitalized, but stays only a few hours after the abortion for
observation. After the 12th week the woman must be admitted to a hospital and
other methods are used. In 1989, 92% of all abortions were carried out before
the end of the 12th week and only 0.6% of all abortions occurred after the
18th week of pregnancy.
Trends in the abortion rate
There were 3,000 reported abortions in Sweden in 1960, and 6,000 in 1965.
Although no change was made in the letter of the law, it was interpreted in
such a way that the number of legal abortions increased from 16,000 in 1970 to
30,600 in 1974. The average increase from one year to the next was around 17%
during these five years.
In 1975, the first year of the new legislation, 32,500 abortions were
performed in Sweden. This was 6% above the 1974 figure. The number of
abortions fell in 1985 to 17.7 per 1,000 women aged 15-44 (30,838 abortions),
since which there has been a slight increase. The corresponding figure in 1989
was 21.5 (37,920 abortions) while in 1975 it was 20.2 (32,500 abortions). Thus
the increase over the 197