PubMedDate not supplied
At the beginning of the 1960s, the Netherlands was basically a conservative society, in which there was little public discussion of birth control or of any sex-related topic. Then, beginning in the 1960s, a series of revolutionary changes in attitudes transformed the Netherlands. The pill was introduced in 1964, and within four years, four out of 10 Dutch women between the ages of 21 and 34 had used it. In 1971, the pill and sterilization were both made available free of charge through the national health insurance plan. By 1974, three-quarters of currently married women 20-42 years of age had ever used the pill, and by 1981, more than 700,000 men and women of reproductive age had had voluntary sterilizations, so that approximately 20 percent of all Dutch couples of reproductive age were protected from pregnancy by sterilization. As might be expected, the wide use of effective contraceptive methods during the late 1960s and the 1970s produced an unprecedented fertility downturn in the Netherlands: The crude birthrate fell from about 20 births per 1,000 population in 1965 to 13 per 1,000 in 1975; the total fertility rate fell from 3.1 births per woman in 1960 to 1.7 in 1975. The birthrate and the abortion rate among teenagers both declined during the 1970s; since sexual activity among teenagers was far more common at the end of the decade than at the start of it, the decline suggests that teenagers used modern contraceptive methods, especially the pill, effectively. At present, contraceptives are widely available, usually at no cost, throughout the Netherlands.(ABSTRACT TRUNCATED AT 250 WORDS)