Research in the field of potential mental health consequences of abortion is characterized by methodological limitations. To offer insight in the mental health of women who have abortions, both before and after the pregnancy termination, a prospective longitudinal cohort study has been conducted, the “Dutch Abortion and Mental Health Study” (DAMHS). This study was designed in a similar way as the large scale Dutch population study into mental health, the “Netherlands Mental Health Survey and Incidence Study-2” (NEMESIS-2). Compared to the NEMESIS-2 reference cohort, DAMHS women more often had experienced mental disorders in the past. The risk of incident mental disorders was however not increased for DAMHS as compared to the reference cohort. Women with a psychiatric history experienced a more stressful pre- and postabortion period, and within this group the risk on recurrent mental disorders might have been slightly elevated (marginally significant) of the short term (2.5 to 3 years) but not on the long term (5 to 6 years). Previous mental disorders were a consistent risk factor, as well as other negative life events and having an unstable relationship with the conception partner. This study does not support the idea that abortion ‘causes’ mental disorders. When post-abortion mental disorders do occur, they are mostly related to vulnerability factors. In this type of research, it is important that psychiatric history is taken into account, as it may explain associations between abortion and post-abortion mental health. In abortion care practice, clinicians could be extra attentive to underlying pre-existing mental health problems.