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BMJ 2011; 342 doi: (Published 01 February 2011) Cite this as: BMJ 2011;342:d606

No link between early abortion and mental illness in Denmark

Between 1995 and 2007, 84 620 Danish women and girls had a first trimester abortion. They were no more likely to see a psychiatrist in the 12 months afterwards than they were in the nine months before, a study has found. Early medical or surgical abortion does not seem to increase the short term risk of mental illness, say the authors, at least not in Denmark where first trimester abortion is legal, widely available, easily accessible, and free.

Incidence rates of inpatient or outpatient psychiatric contact barely changed after abortion (from 14.6 per 1000 person years (95% CI 13.7 to 15.6) to 15.2 (14.4 to 16.1); P=0.19), but went up significantly after first childbirth (from 3.9 per 1000 person years (3.7 to 4.2) to 6.7 (6.4 to 7.0); P<0.001) in a comparison cohort of 280 930 girls and women who delivered their first baby during the same period.

Both cohorts came from Denmark’s comprehensive system of national registers—one that records all residents, one that records all psychiatric contacts, and a third that records all inpatient and outpatient contacts for other reasons, including abortion and childbirth.

Women and girls with a history of mental illness were excluded from both cohorts. Even so, the authors found more psychiatric morbidity in the nine months before a first early abortion, than in the nine months before a first child (14.6 contacts per 1000 person years v 3.9). Women and girls at risk of abortion may well be more vulnerable than women and girls who continue with a pregnancy, say the authors. But the vulnerability clearly comes before the abortion. This study’s findings go against the hypothesis that abortion causes mental illness serious enough to warrant attention from psychiatric services.

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