# paper.pdf ## Metadata - PDFFormatVersion=1.6 - Language=EN-US - IsLinearized=true - IsAcroFormPresent=false - IsXFAPresent=false - IsCollectionPresent=false - IsSignaturesPresent=false - Author=Julia Steinberg - Custom.ContentTypeId=0x0101007428F9ADE1872E4FA280D30F14A22712 - Custom.SourceModified=D:20260623214617 - CreationDate=D:20260623164641-05'00' - Creator=Acrobat PDFMaker 26 for Word - ModDate=D:20260623164645-05'00' - Producer=Adobe PDF Library 26.1.158 - xmp:modifydate=2026-06-23T16:46:45-05:00 - xmp:createdate=2026-06-23T16:46:41-05:00 - xmp:metadatadate=2026-06-23T16:46:45-05:00 - xmp:creatortool=Acrobat PDFMaker 26 for Word - xmpmm:documentid=uuid:25605f7c-0cca-454c-8829-477aeb839ca1 - xmpmm:instanceid=uuid:436564f9-17e1-461b-9994-e07b2098c5fd - xmpmm:subject=3 - dc:format=application/pdf - dc:creator=Julia Steinberg - pdf:producer=Adobe PDF Library 26.1.158 - pdfx:sourcemodified=D:20260623214617 - pdfx:contenttypeid=0x0101007428F9ADE1872E4FA280D30F14A22712 ## Contents ### Page 1 Supplemental Online Content Steinberg JR, Laursen TM, Lidegaard Ø, Munk-Olsen T. Medication and procedural abortion and risk of psychotropic medication use. JAMA Psychiatry. Published online July 22, 2026. doi:10.1001/jamapsychiatry.2025.3698 eTable 1. Incidence Rate Ratios (and 95% CI) of First Psychotropic Medication Prescription, Antidepressant Prescription, and Antianxiety Prescription Comparing Each Time After the Abortion to 1 Year Beforehand Within Method Type for Those Who Had Abortions Between 8 Weeks 0 Days (56 Days) and 8 Weeks 6 Days (62 Days) Gestation (n = 11,726) eTable 2. Incidence Rate Ratios (and 95% CI) of First Psychotropic Medication Prescription, Antidepressant Prescription, and Antianxiety Prescription at Each Time Relative to 1 Year Before the Abortion (n = 67,390) Where 2,500 Women With Both Medication and Procedural Codes Are Placed in the Medication Abortion Group eFigure 1. Incidence Rate of Any Psychotropic Medication Use in Year Before and Year After Abortion (a) for First Procedural Abortion by Gestational Age at Time of Abortion, and (b) for First Medication Abortion by Gestational Age at Time of Abortion eFigure 2. Incidence Rate Ratios of Any Psychotropic Medication Use in Year Before and Year After Abortion, Adjusted for Calendar Year for Females Having Had a (a) First Procedural Abortion by Gestational Age at Time of Abortion, and (b) First Medication Abortion by Gestational Age at Time of Abortion This supplemental material has been provided by the authors to give readers additional information about their work. ### Page 2 eTable 1. Incidence Rate Ratios (and 95% CI) of First Psychotropic Medication Prescription, Antidepressant Prescription, and Antianxiety Prescription Comparing Each Time After the Abortion to 1 Year Beforehand Within Method Type for Those Who Had Abortions Between 8 Weeks 0 Days (56 Days) and 8 Weeks 6 Days (62 Days) Gestation (n = 11,726)a | Unadjusted | Basic Modelb | Fully adjusted modelc | | - | - | - | | Outcome: Any First Psychotropic Medication Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)0.99 (0.78-1.25)1.03 (0.80-1.31)0.90 (0.73-1.10)0.74* (0.60-0.91)1.00 (reference)1.09 (0.95-1.25)0.95 (0.82-1.10)0.99 (0.88-1.12)0.73** (0.65-0.82) | 1.00 (reference)0.99 (0.78-1.26)1.03 (0.81-1.32)0.92 (0.74-1.13)0.85 (0.69-1.05)1.00 (reference)1.07 (0.93-1.22)0.92 (0.79-1.06)0.95 (0.84-1.07)0.77** (0.69-0.88) | 1.00 (reference)0.99 (0.78-1.26)1.04 (0.81-1.32)0.92 (0.75-1.14)0.87 (0.70-1.08)1.00 (reference)1.07 (0.93-1.23)0.93 (0.80-1.07)0.96 (0.85-1.08)0.78** (0.69-0.88) | | Outcome: First Antidepressant Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)1.07 (0.79-1.44)1.12 (0.82-1.52)0.95 (0.73-1.24)0.67* (0.51-0.88)1.00 (reference)1.10 (0.92-1.31)1.03 (0.86-1.24)1.02 (0.88-1.19)0.75** (0.65-0.87) | 1.00 (reference)1.08 (0.80-1.46)1.13 (0.83-1.54)1.00 (0.77-1.30)0.86 (0.65-1.14)1.00 (reference)1.07 (0.90-1.28)0.99 (0.82-1.19)0.97 (0.93-1.13)0.86 (0.74-1.01) | 1.00 (reference)1.08 (0.80-1.47)1.14 (0.84-1.55)1.01 (0.78-1.32)0.89 (0.67-1.17)1.00 (reference)1.08 (0.90-1.29)1.00 (0.83-1.20)0.98 (0.84-1.15)0.87 (0.74-1.02) | | Outcome: Any First Antianxiety Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)0.99 (0.61-1.59)0.98 (0.59-1.60)0.92 (0.61-1.39)0.97 (0.65-1.44)1.00 (reference)1.19 (0.92-1.54)0.76 (0.56-1.02)1.07 (0.86-1.33)0.81 (0.66-1.01) | 1.00 (reference)1.00 (0.62-1.62)1.00 (0.61-1.65)0.97 (0.64-1.47)1.07 (0.71-1.60)1.00 (reference)1.20 (0.93-1.56)0.78 (0.58-1.05)1.12 (0.89-1.41)0.93 (0.74-1.18) | 1.00 (reference)1.01 (0.62-1.63)1.02 (0.62-1.67)1.00 (0.66-1.51)1.14 (0.76-1.71)1.00 (reference)1.22 (0.94-1.57)0.79 (0.59-1.07)1.15 (0.91-1.45)0.98 (0.77-1.25) | ### Page 3 Notes. Relative to the year before an abortion, there are no increased risk after a medication or procedural abortion, respectively, in any first psychotropic medication redemption, any first antidepressant redemption, and any first antianxiety medication redemption. aFor each time period after the abortion, the reference is the year before the abortion within the method. bModel includes abortion method (medication and procedural abortion) and cohort (calendar year). cModel includes abortion method (medication and procedural abortion), cohort (calendar year), age and partner status at time of abortion, psychiatric diagnosis before one year before one’s abortion, childbirth history and Charlson comorbidity index before one year before one’s abortion, father presence during childhood, mother and father income at age 12, and mother and father psychotropic drug use before one year before one’s abortion. *p < 0.05, **p < 0.002 (the Bonferroni-corrected p-value). ### Page 4 eTable 2. Incidence Rate Ratios (and 95% CI) of First Psychotropic Medication Prescription, Antidepressant Prescription, and Antianxiety Prescription at Each Time Relative to 1 Year Before the Abortion (n = 67,390) Where 2,500 Women With Both Medication and Procedural Codes Are Placed in the Medication Abortion Group | Unadjusted | Basic Model* | Fully adjusted model** | | - | - | - | | Outcome: Any First Psychotropic Medication Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)1.07 (0.997-1.16)1.03 (0.95-1.11)0.93* (0.87-0.99)0.74** (0.69-0.79)1.00 (reference)1.10* (1.03-1.19)1.01 (0.94-1.09)0.98 (0.92-1.04)0.77** (0.72-0.82) | 1.00 (reference)1.09* (1.02-1.18)1.06 (0.98-1.14)0.98 (0.92-1.05)0.86** (0.80-0.92)1.00 (reference)1.08* (1.01-1.16)0.98 (0.91-1.06)0.95 (0.89-1.01)0.83** (0.78-0.88) | 1.00 (reference)1.10* (1.02-1.18)1.06 (0.98-1.15)0.99 (0.92-1.05)0.85** (0.79-0.91)1.00 (reference)1.09* (1.01-1.17)0.99 (0.92-1.07)0.96 (0.90-1.02)0.83** (0.78-0.89) | | Outcome: First Antidepressant Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)1.03 (0.94-1.13)1.01 (0.92-1.11)0.87** (0.80-0.95)0.68** (0.62-0.74)1.00 (reference)1.15* (1.05-1.26)1.06 (0.96-1.17)1.06 (0.98-1.14)0.78** (0.72-0.84) | 1.00 (reference)1.06 (0.97-1.17)1.06 (0.96-1.17)0.96 (0.88-1.04)0.87* (0.80-0.95)1.00 (reference)1.12* (1.02-1.23)1.02 (0.93-1.12)1.02 (0.94-1.10)0.90* (0.83-0.98) | 1.00 (reference)1.07 (0.97-1.17)1.06 (0.96-1.17)0.96 (0.88-1.04)0.86** (0.79-0.95)1.00 (reference)1.13* (1.03-1.23)1.03 (0.94-1.13)1.03 (0.95-1.12)0.91* (0.84-0.99) | | Outcome: Any First Antianxiety Prescription | | Medication abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years afterProcedural abortion1 year before<1 year after1-<2 years after2-<5 years after5+ years after | 1.00 (reference)1.22* (1.06-1.40)1.07 (0.92-1.24)1.15* (1.01-1.30)0.99 (0.87-1.12)1.00 (reference)1.11 (0.97-1.28)0.96 (0.83-1.11)0.96 (0.85-1.07)0.87* (0.78-0.97) | 1.00 (reference)1.24* (1.07-1.42)1.09 (0.94-1.27)1.20* (1.06-1.36)1.07 (0.94-1.22)1.00 (reference)1.12 (0.98-1.29)0.97 (0.84-1.12)0.99 (0.88-1.12)0.99 (0.88-1.12) | 1.00 (reference)1.25** (1.08-1.44)1.12 (0.96-1.30)1.25** (1.10-1.41)1.17* (1.02-1.33)1.00 (reference)1.14 (0.99-1.30)0.99 (0.86-1.15)1.03 (0.92-1.17)1.08 (0.96-1.22) | ### Page 5 Notes. Relative to the year before an abortion, there was an increased risk in first antianxiety medication redemption in the year after and 2-5 years after a medication abortion, p ≤ 0.002. aFor each time period after the abortion, the reference is the year before the abortion within the method bModel includes abortion method (medication and procedural abortion) and cohort (calendar year) cModel includes abortion method (medication and procedural abortion), cohort (calendar year), and age, gestational age, and partner status at time of abortion, psychiatric diagnosis before one year before one’s abortion, childbirth history and Charlson comorbidity index before one year before one’s abortion, father presence during childhood, mother and father income at age 12, and mother and father psychotropic drug use before one year before one’s abortion. *p < 0.05, **p < 0.002 (the Bonferroni-corrected p-value). ### Page 6 eFigure 1. Incidence Rate of Any Psychotropic Medication Use in Year Before and Year After Abortion (a) for First Procedural Abortion by Gestational Age at Time of Abortion, and (b) for First Medication Abortion by Gestational Age at Time of Abortion (a) First procedural abortion by gestational age at time of abortion (a.1) < 8 completed weeks (<56 days) gestation (a.2) 8 completed weeks (56 to 62 days) gestation ### Page 7 (a.3) 9-11 complete weeks (63 days to 83 days) gestation (b) First medication abortion by gestational age at time of abortion (b.1) < 8 weeks (<56 days) gestation ### Page 8 (b.2) 8 weeks (56 to 62 days) gestation (b.3) 9 completed -11 completed weeks (63 days to 83 days) gestation Notes: The period -12 to 0 refers to the period of 12 months before the abortion. ### Page 9 eFigure 2. Incidence Rate Ratios of Any Psychotropic Medication Use in Year Before and Year After Abortion, Adjusted for Calendar Year for Females Having Had a (a) First Procedural Abortion by Gestational Age at Time of Abortion, and (b) First Medication Abortion by Gestational Age at Time of Abortion. Reference is incidence rates 11th and 12th months before the abortion. (a) First procedural abortion by gestational age at time of abortion (a.1) < 8 completed weeks (<56 days) gestation (a.2) 8 completed weeks (56 to 62 days) gestation ### Page 10 (a.3) 9-11 completed weeks (63 to 83 days) gestation (b) First medication abortion by gestational age at time of abortion (b.1) < 8 completed weeks (<56 days) gestation ### Page 11 (b.2) 8 completed weeks (56 to 62 days) gestation (b.3) 9-11 completed weeks (63 to 83 days) gestation ### Page 12 Notes: The period -10 to 0 refers to the period of 10 months before the abortion. The solid horizontal line is the reference of 1.00, which is the 11th and 12th month before the abortion method within each gestational age group respectively with the exception of b.3. medication abortion at 9-11 completed weeks gestation. The reference for b.3. medication abortion at 9-11 completed weeks gestation is the 9th to 12th months before the abortion because there were not enough females with the outcome in the 11th and 12th month beforehand. The bars around each point are 95% confidence intervals of the estimate. Within each abortion method and gestational age group, there were only statistically significant higher rates from 4-6 months after a medication abortion at less than 8 completed weeks gestation, p = 0.013, and 5 to 6 months before a medication abortion at 8 completed weeks gestation, p = 0.049, at conventional p-values. These were no longer statistically significantly higher rates when using the Bonferroni-corrected p-value = 0.0045.