title: Decreased suicide rate after induced abortion, after the Current Care Guidelines in Finland 1987-2012.
abstract: OBJECTIVE
  Women with a recent induced abortion have a 3-fold risk for suicide, compared to non-pregnant women. The increased risk was recognised in unofficial guidelines (1996) and Current Care Guidelines (2001) on abortion treatment, highlighting the importance of a check-up 2 - 3 weeks after the termination, to monitor for mental health disorders. We studied the suicide trends after induced abortion in 1987 - 2012 in Finland.
  
  
  METHODS
  We linked the Register on Induced Abortions (N = 284,751) and Cause-of-Death Register (N = 3798 suicides) to identify women who had committed suicide within 1 year after an induced abortion (N = 79). The abortion rates per 100,000 person-years were calculated for 1987 - 1996 (period with no guidelines), 1997 - 2001 (with unofficial guidelines) and 2002 - 2012 (with Current Care Guidelines).
  
  
  RESULTS
  The suicide rate after induced abortion declined by 24%, from 32.4/100,000 in 1987 - 1996 to 24.3/100,000 in 1997 - 2001 and then 24.8/100,000 in 2002 - 2012. The age-adjusted suicide rate among women aged 15 - 49 decreased by 13%; from 11.4/100,000 to 10.4/100,000 and 9.9/100,000, respectively. After induced abortions, the suicide rate increased by 30% among teenagers (to 25/100,000), stagnated for women aged 20 - 24 (at 32/100,000), but decreased by 43% (to 21/100,000) for women aged 25 - 49.
  
  
  CONCLUSIONS
  The excess risk for suicide after induced abortion decreased, but the change was not statistically significant. Women with a recent induced abortion still have a 2-fold suicide risk. A mandatory check-up may decrease this risk. The causes for the increased suicide risk, including mental health prior to pregnancy and the social circumstances, should be investigated further.
authors.affiliation: National Institute for Health and Welfare (THL), Helsinki, Finland NHV Nordic School of Public Health, Gothenburg, Sweden mika.gissler@thl.fi.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Helsinki Central University Hospital, Helsinki, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Karalis
authors.affiliation: Helsinki Central University Hospital, Helsinki, Finland.
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Ulander
mesh_terms: D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D005260:Female; D005387:Finland; D006801:Humans; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D018570:Risk Assessment; D013405:Suicide / Q000639:trends; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Abortion; Current Care Guidelines; Finland; induced abortion; suicide prevention; suicide risk