Anti-abortion groups, having largely failed to convince the American public that abortion is morally abhorrent, have tried to shift the debate to their concern about women’s health. The same groups who would forbid abortion after rape or incest, or when the mother’s life is endangered claim to be saving women from “post-abortion syndrome”, a mythical psychological disorder. There are many reasons good people may oppose abortion, but lying about health risks such as breast cancer (a long-discredited hypothesis) is simply immoral. But it does seem plausible that abortion might have psychological consequences, although whether these would be good or bad certainly isn’t obvious. A new Danish cohort study published in the New England Journal of Medicine tries to inject some data into this debate.
The study relies on the excellent health records kept by the Danish health care system. They looked at the approximately 3/4 million women born between 1962-1993. They were able to find out how who sought psychiatric care (there is no private psychiatric care in Denmark), and who had abortions or gave birth. Abortions before 12 weeks gestation are legal in Denmark, and nearly all abortions there are done during that period, and nearly all are performed in public clinics or hospitals, so the data are pretty complete.
Combing this data, the authors identified a study population of young women with no history of psychiatric disease and no history of abortion. They then compared rates of psychiatric care sought in the period from 9 months before abortion or child birth until 12 months after. They crunched the numbers and the crux of their conclusion was:
The risk of a psychiatric contact did not differ significantly before and after abortion (P=0.19), but the risk after childbirth was significantly greater than the risk before childbirth (P<0.001).
The primary finding was that women who had abortions were just as likely to seek out psychiatric care before their pregnancy as after their abortion. Having an abortion was not a risk factor for seeking out psychiatric care.
This is an impressive study, made possible by the excellent data collection in Denmark. Abortion, medical, and psychiatric care are all easily available, significantly lowering confounding economic and social factors that might be found in the US, and in this population, abortion did not appear to lead to psychological illness. The interesting secondary finding, that having a baby can lead to psychological distress, is a fact often left out by anti-abortion groups. Post-partum depression and anxiety are common and serious. Since the question of abortion and mental health is largely asked and answered, it is time to focus our energies on groups truly at risk.
Munk-Olsen, T., Laursen, T., Pedersen, C., Lidegaard, �., & Mortensen, P. (2011). Induced First-Trimester Abortion and Risk of Mental Disorder New England Journal of Medicine, 364 (4), 332-339 DOI: 10.1056/NEJMoa0905882