One of the many reasons policymakers often give for restricting abortion access is that the procedure causes depression. A new study finds no evidence of such claims.
Of course, it’s not the only study to debunk this particular talking point. The difference is that this study, published May 30 in JAMA Psychiatry, is based on documented patient care records instead of patient self-reporting, which is susceptible to bias and the pressures of social stigma. In the new study, researchers found that while women who had an abortion did have a higher risk of antidepressant use than women who did not, that risk remained steady from the year before the abortion to the year after having had an abortion. They also found that the risk of antidepressant use steadily went down in the time following an abortion.
All together, the findings suggest that the higher antidepressant risk isn’t due to abortion, but to a pre-existing condition. In other words, there’s no evidence that abortion is the cause of higher antidepressant use.
“There are a number of states that require that providers tell women that abortion causes mental health problems, but there’s no scientific evidence for that,” study co-author Julia Steinberg, an assistant professor of family science at the University of Maryland School of Public Health, told me. “There’s an association — women who get an abortion are more likely to use antidepressants — but the association isn’t due to abortion.”
To bypass the problems of self-reported data, Steinberg and colleagues examined data from official Danish registries that capture information on prescriptions, hospital-based abortion care and childbirth. In all, the data included more than 396,000 women born in Denmark between 1980 and 1994. Researchers used antidepressant use as a proxy for depression. They found that among women who had an abortion, the likelihood of using antidepressants didn’t change from the year before having an abortion to the year after, with that likelihood declining significantly in the five years following an abortion, which contradicts claims that abortion has long-term adverse impacts.
However, researchers did find differences among Danish women who had a child during the study period. According to the study, childbirth was associated with a decreased risk of antidepressant use in the year before childbirth and the year after birth when compared to other women. However, in the year after giving birth, absolute rates of antidepressant use went up among those women. That is to say, the risk of antidepressant use did not remain steady for women who gave birth, as it did for women who had an abortion, even though their post-birth likelihood of taking antidepressants was still lower than for other women. In fact, the study found that while the risk of antidepressant use declined in the years following an abortion, it increased in the years following childbirth.
Steinberg said those findings suggest that many women don’t want to take medication during pregnancy, while post-birth surges in antidepressant use may reflect women struggling with post-partum depression. She and study co-authors Thomas Laursen, Nancy Adler, Christiane Gasse, Esben Agerbo and Trine Munk-Olsen conclude:
The differences in rates of antidepressant use between women who had an abortion and women who did not have an abortion were substantially reduced when adjusted for earlier mental health conditions, parental mental health conditions, parental educational level, and physical health. This suggests that, compared with women who do not have an abortion, women who have an abortion may be at higher risk of depression after undergoing the procedure because they were at higher risk to begin with. Consequently, policies based on the notion that having an abortion harms women’s mental health may be misinformed.
Steinberg told me that she wasn’t surprised at the findings, as two previous studies also based on Danish medical registries and looking for associations between abortion and psychiatric admissions revealed similar results. Those studies also found no difference in psychiatric admissions before and after abortion, whereas it did find that psychiatric admissions went up after childbirth. The new study also echoes findings from a report on abortion quality and safety released earlier this year from the National Academies of Sciences, Engineering and Medicine, which found that abortion does not increase the risk of mental health illnesses such as depression or post-traumatic stress disorder.
While there are certainly differences between the Danish and American health systems, as well as differences in social stigmas related to mental illness and abortion, Steinberg said there’s no reason to believe that American women don’t have a similar experience.
“As a society, we can debate abortion laws, but we can’t debate what the science says,” she told me. “Laws based on the notion that abortion harms women’s mental health are not based in scientific evidence.”
To request a full copy of the new study, visit JAMA Psychiatry.