Objective: To describe the differences in childbearing, in prenatal and obstetrical practices, and in perinatal health outcome in Finland and Estonia.
Design: Registry study using the data from the Finnish and Estonian medical birth registries for years 1992 to 1996 (in total 324,021 and 74,297 newborns, respectively).
Results: In 1992 the birth rates were 51 per 1,000 women aged 15 to 49 in Finland and 48 per 1,000 in Estonia. The birth rate declined in the study period in both countries, but the decline was more rapid in Estonia (-26%) than in Finland (-6%). In the same period the rates of induced abortion declined in both countries (-34% and -6%, respectively), but the rate in 1996 was still much higher in Estonia (46/1,000) than in Finland (8/1,000). Compared with Finnish mothers, Estonian mothers were younger, had fewer multiple births, less prenatal care and fewer interventions during pregnancy and delivery. The intervention rates increased in both countries during the study period, but this increase was more rapid in Estonia. The infant outcomes were poorer in Estonia, but the differences between Estonia and Finland decreased during the 1990's.
Conclusions: The differences in prenatal and maternal care and in induced abortion rates have decreased between Estonia and Finland. Changes in maternal backgrounds, improved referral system for complicated pregnancies, improvements in prenatal care and in availability of appropriate equipment and technology may have caused improved maternal and infant health in Estonia, but this should be further investigated.