Discussion
Reanalysis of the differences between pre- and post-abortion first-time psychiatric contact in the Danish medical records revealed that in the full one-year period following abortion the rate at which women sought mental health care after an abortion was 1.49 times higher (95% CI: 1.37 to 1.63) than the rate in the nine months prior to an abortion. Statistical significance was also noted when the time frame of consideration was nine months, a period equal to the pre-abortion observation period.
These findings suggest that abortion’s effect size on mental health is relatively small and can be easily missed when analyses are restricted to shorter time periods. The Danish research team’s methodology was almost entirely focused on short time periods, even as short as a single month. This was an oversight since the best evidence indicates that most women will be able to successfully repress abortion related stresses for at least a moderate period of time.[1,8–10]
This reanalysis confirms that the Danish data, when examined over periods of at least nine months, is consistent with the findings of both records-based[3,4,12,13] and survey-based studies.[1,11,14–18] Therefore, the authors of the original study erred in their conclusion that first-time contact rates before and after an abortion are not significantly different in Danish medical records.[2] The differences are significant. Moreover, our reanalysis shows that these differences are likely to become increasingly evident when the period of follow-up is extended beyond one year. Inclusion of cases beyond one year is advisable to encompass both anniversary reactions and the exhaustion of repression and other coping mechanisms which may delay the most significant post-abortion reactions.