TERMINATION OF PREGNANCY AND PSYCHIATRIC MORBIDITY

Background. We investigated whether reported psychiatric morbidity was increased after termination of pregnancy compared with other outcomes of an unplanned pregnancy. Method. This was a prospective cohort stud y of 13261 women with an unplanned pregnancy. Psychiatric morbidity re ported by GPs after the conclusion of the pregnancy was compared in fo ur groups: women who had a termination of pregnancy (6410), women who did not request a termination (6151), women who were refused a termina tion (379), and women who changed their minds before the termination w as performed (321). Results. Rates of total reported psychiatric disor der were no higher after termination of pregnancy than after childbirt h. Women with a previous history of psychiatric illness were most at r isk of disorder after the end of their pregnancy, whatever its outcome . Women without a previous history of psychosis had an apparently lowe r risk of psychosis after termination than postpartum (relative risk R R=0.4, 95% confidence interval CI=0.3-0.7), bur rates of psychosis lea ding to hospital admission were similar. In women with no previous his tory of psychiatric illness, deliberate self-harm (DSH) was more commo n in those who had a termination (RR 1.7, 95% CI 1.1-2.6), or who were refused a termination (RR 2.9, 95% CI 1.3-6.3). Conclusions. The find ings on DSH are probably explicable by confounding variables, such as adverse social factors, associated both with the request for terminati on and with subsequent self-harm. No overall increase in reported psyc hiatric morbidity was found.