This Danish population-based registry cohort study followed 67,390 females aged 12–38 years who had a first elective first-trimester abortion (medication or procedural) between 2000 and 2018, tracking first psychotropic, antidepressant, and antianxiety prescription redemptions from 1 year before abortion until end of follow-up (max December 31, 2018).
In fully adjusted models, small increased risks of any first psychotropic medication redemption were seen in the first year after both medication abortion (IRR 1.10; 95% CI 1.02–1.19) and procedural abortion (IRR 1.09; 95% CI 1.01–1.16), but these were no longer significant after Bonferroni correction (threshold p=0.002). Risks fell significantly more than 5 years post-abortion for both methods (medication: IRR 0.85; procedural: IRR 0.83; both p<0.001). In a sensitivity analysis, antianxiety prescriptions were significantly elevated in the year after and 2–5 years after medication abortion even after Bonferroni correction.
- Study uses psychotropic prescription redemption as a proxy for mental health problems; it cannot capture untreated conditions or severity. - Danish registry data may not generalize to other healthcare systems or populations with different abortion access contexts. - The within-person design controls for many confounders but cannot fully rule out unmeasured time-varying factors (e.g., relationship changes, life stressors) coinciding with abortion timing.
Neither medication nor procedural abortion was associated with a clinically meaningful or statistically robust increase in psychotropic medication use after correction for multiple comparisons — reassuring counseling data for patients and clinicians. Long-term (>5 years), psychotropic prescription rates actually fell below pre-abortion levels for both methods.
