Introduction: Having a child at a young age can have long-lasting effects. Prevention is therefore of utmost importance. Icelandic adolescents have been found to start earlier to have sexual intercouse and have higher pregnancy rates than their counterparts in the other Nordic countries. The trends in these rates are explored and the reasons behind these higher rates among Icelandic adolescent girls by focusing on sexual and reproductive health services. Methods: The registered abortion, fertility and pregnancy rates among adolescent girls 15-19 years are compared between Iceland, Finland, Denmark, Norway and Sweden during the period 1976-2002. A national survey was conducted among 2500 adolescents 17-20 years old to explore their attitudes towards sexual and reproductive health services. Results: The higher pregnancy rates among Icelandic adolescent girls existed over the entire study period. The trend among the Icelandic adolescent girls has been to carry to term rather than having an abortion. This has been quite the reverse in the other Nordic countries where adolescent girls have more frequently had an abortion. Adolescents in Iceland sense many hindrances in becoming sexually responsible. Services are in many cases not attractive to them and they find the cost of contraceptive methods too high. Conclusions: According to the present abortion law from 1975, information and counseling should be provided in all primary health centers and in hospitals in Iceland. The services have not until recently been youth focused. The first youth clinic was established within the primary health care services in 1999. Adolescents have therefore through the years lacked services which are geared to their needs.
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