Regional elections “Not everything can be passed on to society” – Free prevention for young people is not a good idea

Should young people get their contraceptives from society for free? If so, how old?

These questions are most severely addressed in South Karelia, according to the answers given by the candidates. To the HS regional election machine. The differences between the regions were not large.

In terms of prevention, however, South Karelia differs from many other parts of Finland. Free contraception has not yet been offered to young people in any municipality. Not even in the largest city in the area, Lappeenranta.

“Young people should have the opportunity for free contraception,” says the Lappeenranta resident Elisa Pikova.

A group of former and current Lappeenranta residents have gathered on the sofa of the café, and the position of 20-year-old friends is clear.

“If prevention wasn’t free, it would be good to have even some kind of monthly support,” Pikova continues.

Sara Mänttäri has traveled to his parents in Lappeenranta on his Christmas holiday from Joensuu, Tia Bäcker From Helsinki and Pyry Eskelinen From Holland. For example, the new hometowns of Mänttär and Bäcker are in a different country than Lappeenranta. In Joensuu, everyone under the age of 20 receives long-term contraception, in Helsinki, everyone under the age of 25 receives it.

Municipalities they can decide for themselves whether to give contraception to young people free of charge.

When the pharmaceutical company Bayer clarified the situation last November, it became clear that South Karelia, Kainuu and Päijät-Häme are the only future welfare areas where no municipality offers such.

During the regional elections, free prevention for those under the age of 25 has been demanded, for example, by the umbrella organization Alliance, a youth organization, and the Population Association.

The idea is by no means new, as free contraception for young people was recommended in a national sexual and reproductive health promotion project launched 15 years ago. action program.

The issue came to the fore in the 1990s, when abortions for young people began to increase in Finland, says a research professor at the National Institute for Health and Welfare (THL). Mika Gissler. According to him, the small number of abortions has been considered a measure of the state of adolescent reproductive health services.

“The idea was that young people should have such good information and access to services that unwanted pregnancies could be avoided,” Gissler says.

In the aftermath of the recession, municipalities were reluctant to pay for contraception for young people. The idea finally came to fruition and only began to become widespread in the 2010s.

For example The results of free contraception in Vantaa have been promising: offering a free contraceptive coil and capsule reduced the risk of abortion by up to 80 percent, 2020 published dissertation.

“The dissertation shows that free contraception is effective. As soon as free contraception is introduced in general, the number of abortions for young people will fall in a couple of months, ”says Gissler.

Now some municipalities only offer free contraception to those under 20 years of age. THL has recommended that free contraception should be extended to 20-24 year olds.

The proposal is supported by statistics: abortions in 20-24 year olds have not declined at the same rate as in younger ones.

THL has also justified its position on the grounds of equality, the reduction of sexually transmitted diseases and the fact that free treatment would improve the preventive side of healthcare.

“Our health care is often more remedial than preventative. When it comes to counseling and treatment that begins before pregnancy, it is important that future fertility is pampered, ”says Gissler.

He points out that it is not just about prevention. At the same time, the young person has the opportunity to talk to a health care professional about reproductive health other than the need to prevent pregnancy and STDs.

“There is an opportunity to discuss, for example, the prospect of further enlargement. Whether children are planned and at what age to start having a child, ”says Gissler.

“The most important point is to be close to the services and be able to provide them. Not everyone may need prevention, but within the service system, they are directed to the right services if there are social problems, for example, ”says Gissler.

Free of charge the benefits of prevention to society can no longer be justified by direct costs alone, according to Gissler.

Because fewer abortions are now performed on young people, on an annual basis, long-term contraception for this age group costs society more than annual abortions for this age group.

Even the medical rationale is no longer the same as before. At present, abortion is medically performed and has no effect on future pregnancies in the same way as previously used surgical methods.

What kind arguments then oppose it?

In the HS election machine, the most common negative views were among basic Finns and Christian Democrats. Free contraception, on the other hand, came from the Greens and the Left.

Many of the opponents cited low birth rates, for example. It was also seen that prevention should take financial responsibility itself at the dawn of adulthood.

“Not everything can be passed on to society,” explains the Christian Democrat candidate Eija Hauska-Mertanen Imatralta.

“Everyone can take care of their own contraception,” writes the candidate for basic Finns Riku Shields From Lappeenranta.

Coalition candidate and chairman of Lemi Municipal Council Juha Mielikäinen, 53, says “is too old to deal with such issues”.

“Personally, it’s not quite clear to me what’s behind this free contraception. I have not received an explanation as to why this issue is being pushed so hard forward, ”he says.

According to Mielikäinen, the costs of abortions in Exote are so low that there is no reason to increase free contraception.

“It may be wiser for me to say that this is important, but with the information I have received, I am not the first to support and take it forward.”

Even though Lemi has an aging population, there is no hope for an improved birth rate.

“I would say that yes, the municipality’s population needs to be increased in some other way.”

As affairs stand municipal practices are diverse even within the same welfare area.

For example, in Northern Savonia, Kuopio and Siilinjärvi offer contraception free of charge to anyone under the age of 25, while in Iisalmi and Varkaus, contraception is offered to anyone under the age of 20. Other municipalities in the area do not offer contraception to young people for free at all.

“It will certainly be a discussion in the councils as to whether to go according to the municipality that provides the most or the least welfare area,” Gissler says.

In Lappeenranta friends gathered in the cafeteria think the rainbow youth are being ignored in the conversation. They see that contraception is talked about very heteronormatively.

“There is no easy reliable information on male-to-male contraception or HIV prevention online. And there is no free contraception, ”says Pyry Eskelinen.

They point out that heteronormativity is also indicated by the fact that free contraception is justified by a reduction in abortions. So a woman’s sex partner is assumed to be a man and vice versa.

In particular, they think the school focuses more on talking about pregnancy than about preventing disease.

“In a high school first grade health check, a nurse asked if I was taking e-pills, and that was it. And I didn’t dare question it then when the pills were recommended, ”Bäcker says.

“But they do not prevent disease. And e-pills are not necessarily a useful method for female couples, for example. ”

How could the situation be improved? According to them, for example, by distributing different condoms – this would take into account different ways of having sex.

“Non-hormonal alternatives should also be available. Not by pushing e-pills first and then condoms. The use of hormonal contraception should be your choice, ”says Elisa Pikova and others nod.

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“There is no easy way to find reliable information on contraception on the Internet.”

For example, in Helsinki, people under the age of 25 receive birth control pills or a contraceptive ring for free for a year. A copper or hormone coil and a contraceptive implant are available until the upper age limit is reached. Condoms are also available.

“Condoms sharing would be the easiest option, ”says a 21-year-old from Lappeenranta Joona Vänttinen on the other side of town in front of a chessboard.

He follows peers Jaakko Nikkinen and Patrik Stenmanin game, sometimes sipping local coffee. In Lappeenranta, high school friends agree to offer free contraception to young people.

In their opinion, condoms could also be distributed more widely at various events in addition to schools. They recall that there was talk of contraception in middle school, but at the age of 15, it was mostly giggled in the gang.

“Just on the eve of adolescence [kondomien] Buying is a taboo for many, which is why free prevention would be a good thing, ”says Stenman.

“We have been in a good position because the price was not a problem even at a young age. Not everyone has a pair of euros in condoms, ”Vänttinen points out.

For example, Kela reimbursements for hormonal contraception could be obtained at a pharmacy, or they could be completely free. “Especially e-pills are expensive,” says Vänttinen.

Vänttinen and Nikkinen say they have shared the cost of contraception with their girlfriends.

“Participating in the costs is fair. E-pills have been designed for men, but at least they don’t exist yet, ”says Nikkinen.

Today a trial of free contraception is also planned to begin in South Karelia. The Social and Health District of South Karelia (Eksote) is carrying out the experiment as part of a project related to the Sote reform, for which a state grant is promised. The newspaper has reported on the matter, for example Southern Saimaa.

An experiment with free contraception was recorded Sanna Marinin (sd) government program. Due to the corona epidemic, the experiment will only be launched in the applicant areas this year.

According to THL’s Gissler, the results of the experiment will not be available during this term. He hopes that the matter will come up in the councils of new welfare areas.