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Leena Ruusuvaara M.D., Ph.D. Finland

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Presentation on theme: "Leena Ruusuvaara M.D., Ph.D. Finland"— Presentation transcript:

1 Leena Ruusuvaara M.D., Ph.D. Finland

2 Same goal Different approach Healthy young Adults Children
guided by religion, culture, tradition and economy

3 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

4 Ways to reproductive health
Knowledge Services Non-judgemental environment

5 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

6 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

7 70% of 18 year olds are sexually active
One cannot afford to ignore the needs of sexually active teenagers Advocates for youth

8 Our main goal (as parents, politicians and health care personnal) shoud be:
”Helping young people make safe and responsible decisions about sex”

9 ”Safe sex” or ”No sex”

10 Media Congressionally mandated approach U.S. Just do it Just say NO

11 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

12 Reproductive health SOMA PSYCHE reproduction relationships
therapy communication medical control own ”control” = responsibility technical language colloquial language preventive measures preventive behaviour

13 Myths 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

14 Myths 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

15 Myths 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

16 Myths 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

17 The number of abortions
does NOT tell the number of unwanted pregnancies

18 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

19 Psychosomatic prevention of (sexual) risk behavior
Learn to identify those at risk Depressive behaviour Even relatively short psychiatric intervention can have great impact

20 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)

21 (cultural, religion etc.)
Education Sex education Social situation (cultural, religion etc.) Education Sex education Social situation Yes, I am ready I can do it No, it is not the right time, yet

22 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

23 Abortions in Finland Abortions in U.S.A.
< 20 years of age / 1000 Stakes 2005 Abortions in U.S.A. < 20 years of age 20 / 1000 Advocates for youth, 2002

24 History and development
Borlänge 1970 Gustav Högberg Child 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

25 Health on equal terms Swedish 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.”

26 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

27 Scandinavian Countries
School Education HIGH Teenage Pregnancy rate (birth & abortion) LOW Scandinavian Countries Japan Germany U.K. U.S.A. Kenya India Bangladesh Adapted from into a New World, The Alan Cuttmacher Institute, May 1998

28 Experiences School personnel need support Parents need support
Grown-ups need up-to-date information

29 Casual sex No contraception No consequences And – often –
no deeper feeling for each other

30 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

31 Elise Ottensen Jensen (1886-1973)
”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 ( ) One of the first women who lectured about reproductive health

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