Abortion was not followed by a lasting rise in psychotropic prescribing, by either method

Design

Population-based registry cohort, within-person comparison

Population

67,390 women in Denmark with a first first-trimester abortion, 2000-2018

Primary outcome

First psychotropic prescription redemption

Effect

Year 1 IRR 1.10 (medication) and 1.09 (procedural), not significant after correction; >5 years IRR 0.85 and 0.83

A Danish population-registry cohort (JAMA Psychiatry, 1 October 2026) followed 67,390 women aged 12-38 having a first elective first-trimester abortion between 2000 and 2018: 33,793 medication and 33,597 procedural. Each woman's rate of first psychotropic prescription redemption was compared with her own rate in the year before the abortion.

In the first year after abortion there was a small rise for both methods (medication IRR 1.10, 95% CI 1.02-1.19; procedural IRR 1.09, 1.01-1.16). Neither met the Bonferroni-corrected threshold the authors used for multiple testing. There was no association at one to two or two to five years, and rates were lower more than five years later (IRR 0.85 and 0.83), a finding that did survive correction.

For counselling, this supports telling women that neither medication nor procedural abortion was linked to a lasting increase in needing psychotropic medicines. A prescription is a proxy for mild mental health problems rather than a diagnosis, and the year before an abortion may itself be a stressful time, which makes a pre-abortion baseline imperfect.

• When counselling, explain that neither abortion method was linked to a lasting rise in psychotropic prescribing.
• The choice between medication and procedural abortion need not be driven by mental health concerns on this evidence.
• Offer follow-up in the first year to women with a prior psychiatric history, where any short-term increase is most plausible.
• Ask about mood at post-abortion review as part of routine care.

Why it matters

It answers a question clinicians are asked in counselling with large, method-specific population data.

Don't overread it

Prescription redemption is a proxy for mild mental health problems, and observational data cannot show the abortion caused the small first-year change.

The statistics, in plain English

An IRR of 1.10 means about 10% more first prescriptions than in the year before. Because many comparisons were tested, the authors used a stricter Bonferroni threshold, and these small first-year rises did not pass it, so they may be chance.

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