Trends in teenage fertility, abortion, and pregnancy rates in Iceland compared with other Nordic countries, 1976-99

Background. Iceland is often considered very similar to the other Nordic countries. The purpose of this study was to explore trends in teenage fertility, abortion, and pregnancy rates in Iceland, compare these trends with corresponding rates in Denmark, Finland, Norway, and Sweden during the period 1976-99, and to evaluate similarities and dissimilarities. Methods. The study is based on data about fertility, abortion, and pregnancy rates obtained from the Icelandic and Nordic national population and abortion registers for the age group 15-19 years years. Results. Teenage fertility and pregnancy rates in the five Nordic countries declined over the study period by 57-67% and 31-50%, respectively, and in Iceland they remained significantly higher than in the Nordic countries. In 1999 almost every other teenage pregnancy in Iceland (45.9/1000) resulted in a childbirth (24.4/1000). Regional fertility rates were highest in the countryside. While the abortion rate has been declining in the four Nordic countries by 20-41%, they have concurrently been rising in Iceland by 133% (9.4/1000 in 1976-80, 21.9/1000 in 1996-99) and are presently higher than in the other Nordic countries. Regionally, abortion rates in Iceland were highest in the Capital area. Conclusions. The teenage pregnancy rate is higher in Iceland than in the other Nordic countries. This may be explained by cultural norms in Iceland's society regarding childbearing, early initiation of sexual intercourse, more limited sex education, and less effective delivery and use of contraceptive methods. There is a need to promote sexual and reproductive health to young people in Iceland by combining diverse preventive approaches.