Not only does the Netherlands have the lowest induced abortion rate in the world, but Dutch youth have the lowest rates of both adolescent pregnancy and abortion. This record is attributed to a general stance of openness and acceptance of sexuality as a healthy part of life that emerged in 1965-75 in response to recognition of the public health impact of unwanted pregnancy. Modern contraceptives (excluding condoms) are provided at no charge by the national health service and are easily accessible to teenagers. Sex education, which begins at an early age, seeks to instill skills that enhance partner communication and negotiation. By the late 1980s, unplanned births represented only 6% of all first births. In 1992, 38% of Dutch women terminated their first pregnancy compared with 47% in the US; that same year, the Dutch adolescent pregnancy rate was 9.2/1000 women 15-19 years old compared with 95.9/1000 in the US. In 1995, 85% of Dutch youth used contraception at first intercourse (46% condom, 13% pill, 24% pill and condom, and 1% other method). Overall, the Dutch experience suggests that a less ambivalent public approach to sexuality might encourage more responsible reproductive behavior in the US.
