Abstract
Background: A previous study of Danish medical records reported
that the monthly rate of first-time psychiatric contact following a
first induced abortion was greater than the rate following a first live
birth but not dissimilar to the average monthly rate nine months prior
to the induced abortions. The research team therefore concluded that
abortion has no independent effect on mental health and the differences
between psychiatric contacts after abortion and delivery were entirely
attributable to pre-existing differences in prior mental health. These
conclusions are inconsistent with similar studies published before and
after this Danish analysis, and its methodology was arguably inferior in
a number of important ways. Most importantly, there is a need to
reanalyze the data provided over a longer period of time in order to
account for effects that may be missed when the time periods of analyses
are too short.
Method: Monthly and tri-monthly data was extracted from the
original study and configured to allow analyses of the cumulative
effects over nine- and twelve-months post-abortion.
Results: Across all psychiatric diagnoses, first-time
psychiatric contact increased from an odds ratio of 1.12 (95% CI: 1.02
to 1.22) to 1.49 (95% CI: 1.37 to 1.63) for the cumulative
post-abortion periods of 9 months and 12 months, respectively, as
compared to the 9 months pre-abortion. At 12 months post-abortion, the
rates of psychiatric diagnosis were significantly higher across all four
diagnostic groupings and most strongly for personality or behavioral
disorders (OR=1.87; 95% CI:1.48 to 2.36) and neurotic, stress related,
or somatoform disorders (OR=1.60; 95% CI: 1.41 to 1.81).
Conclusions: When analyzed over longer time frames, results
from the Danish data are now consistent with the larger body of both
record-based and survey-based studies. Analyses of mental health effects
associated with abortion should include observation periods of no less
than nine months and preferably over one year in order to encompass both
anniversary reactions and the exhaustion of coping mechanisms which may
delay observation of post-abortion effects.