Women who have had an abortion are more likely to use antidepressants than women who have not had an abortion, but new research suggests that this association is a result of differences in risk factors for depression.
“Thus, policies based on the notion that abortion harms women’s mental health may be misinformed,” wrote Julia R. Steinberg, PhD, and her coauthors in JAMA Psychiatry.
Dr. Steinberg and her coauthors looked at a cohort of Danish women, intending to examine the association between first-time antidepressant use and either first-trimester abortion or first childbirth. “One shortcoming of many studies in the field is their reliance on self-report of both abortion and mental health problems, which is subject to both faulty memory and social desirability in reporting,” wrote Dr. Steinberg of the University of Maryland, College Park, and her coauthors. Using data on abortion, childbirth, and antidepressants from the Danish population registries, which were collected over time, avoided that limitation.
Of the 396,397 women, 17,294 (4.4%) had at least one first-trimester abortion and no children, 72,052 (18.2%) had no abortions and at least one childbirth, 13,540 (3.4%) had at least one abortion and at least one childbirth, and 293,511 (74.1%) had neither an abortion nor a childbirth.
Of 30,834 women who had an abortion and filled at least one antidepressant prescription, 5,705 (18.5%) initiated antidepressant use after a first abortion. Of 85,592 women who gave birth and filled at least one antidepressant prescription, 10,825 (12.7%) initiated antidepressant use after a first childbirth.
The researchers were limited to 2-month increments of incidence rates for patient confidentiality reasons.
While women who had an abortion were more likely than women who had not to obtain an antidepressant prescription, “the rate of new antidepressant use was the same in the year before and year after and decreased with increasing time after the abortion,” the researchers wrote. “ after the abortion.”