Sexual behaviour, contraceptive use, and family planning intentions: 30 years of repeated cross-sectional surveys.

Purpose: Globally, women are postponing childbearing and total fertility rates are decreasing. In Sweden, a 2018 law requires consent before sexual activity and LARC is now recommended as a first-hand choice. This study compares sexual behaviour (including consent), contraceptive use and family planning intentions with past surveys.

Material and methods: This is a cross-sectional survey that has been repeated every fifth-tenth year since 1989 in Sweden. It explores sexual behaviour, contraceptive use and family planning intentions among women attending a gynaecology clinic for contraceptive counselling and compares these results with previous surveys.

Results: Of the 596 women surveyed, 558 were sexually experienced, the majority (98%) of which perceived consent during their most recent sexual activity. Over 30 years, there was a significant trend towards having more sexual partners (p = 0.02). The use of SARC (p = <0.01) and LARC (p = 0.04) has increased since 2014, while condom use and emergency contraceptive use have decreased (p = <0.01 for both). Three out of four respondents (n = 449) wanted children, significantly fewer than 2014.

Conclusions: Sexual behaviour and contraceptive use have changed over the last ten years in Sweden. More women use effective forms of contraception and informed consent laws may have positive implications. Yet fewer women have decided to have children in the future.