According to a research released Tuesday in the journal BMJ Sexual & Reproductive Health, many women are taken aback by the level of agony they endure during a medication abortion.
Medication abortions, in which the woman takes two medications, usually at home, to terminate the pregnancy, account for more than 60% of abortions performed in the United States.
According to the study, which polled women in the UK, many of them are unprepared for the level of agony they could experience during the surgery.
Although some women may be taken aback by the information they received from medical professionals, pain does not indicate that the treatment is hazardous.
Doctor Alyssa Colwill, an associate professor of obstetrics and gynecology at the Oregon Health and Science University School of Medicine, who was not involved in the new study, stated, “There is a bit of a reckoning in the world of gynecology right now and the pain patients are experiencing during procedures.”
Researchers examined survey answers from over 1,600 women in the United Kingdom who had had medication abortions and then responded to questions about their experiences. Half of them had never given birth, and the majority were between the ages of 20 and 39.
About half of the respondents stated that the pain was more than they had anticipated, and over 90% gave their agony at least a 4 out of a possible 10. On a pain rating of 8 to 10, around 40% of respondents reported having severe pain.
During a medication abortion, women in the U.S. and the U.K. are frequently informed that they should anticipate cramping similar to severe menstruation cramps. Some respondents indicated they felt unprepared and that the agony associated with medication abortion was “sugar-coated” or minimized, while others thought that was a fair description.
“The pain was so much stronger than period pain, it was like having contractions in labor,” one lady who answered the poll stated. I’ve given birth three times, and each time the agony was much the same—a cramping contraction.
“I believe it’s important to reassure people that just because the pain is described as severe, it doesn’t necessarily mean that it will be,” another person noted. I worried about the potential side effects for longer than was necessary.
The researchers came to the conclusion that women required broad anticipatory guidance and comprehensive, realistic pain counseling, including first-hand accounts that showed the spectrum of suffering that women may feel following medication abortion.
In an email, Hannah McCulloch, an assessment researcher at the British Pregnancy Advisory Service and the study’s primary author, stated, “What’s important here is the acknowledgement that everyone’s experience of pain during a medical abortion will be different.” “In order to provide meaningful patient-centered care, it is important to be realistic about what women go through during medical abortion.”
Two tablets are taken during a medication abortion. The first, mifepristone, inhibits progesterone, a hormone essential to the continuation of pregnancy.
The individual takes a second medication, often misoprostol, one or two days after taking mifepristone. This medication causes the uterus to relax and cramp, and the cervix to dilate so the pregnancy may end, generally within 24 hours of taking misoprostol, Colwill said.
“That process, the uterus having to cramp and expel the pregnancy, is going to cause pain inherently,” she said, adding that each person’s level of discomfort is influenced by a variety of circumstances.
According to Colwill, women who have had labor or given birth vaginally, as well as those who suffer from intense monthly menstrual cramps, such as those who have endometriosis, may report less discomfort with a pharmaceutical abortion.
She continued, saying that it was not surprising that many women did not feel sufficiently prepared to manage pain during a medication abortion. “Understanding these past experiences, and things like how they experience Pap smears and vaginal exams, can help us better support patients to be prepared for how pain may be for them,” she said.
Abortion with medication is a very safe operation. According to the drug’s label, less than 0.5% of persons using Mifeprex, the brand-name form of mifepristone, experience serious adverse effects, and since the Supreme Court reversed Roe v. Wade in 2022, more women are handling their own abortions.
“Patients must be given sufficient information about what to anticipate and what we know about pain management.” Dr. Daniel Grossman, a professor of obstetrics and gynecology and the head of the University of California San Francisco’s initiative to advance new standards in reproductive health, stated that pain is minimized in medicine generally and in women’s health and obstetrics and gynecology specifically.
According to Grossman, patients should still receive counseling on how to manage the severe pain and nausea that may occur during the surgery, even if they obtain abortion drugs via telehealth.
He stated that using a nonsteroidal anti-inflammatory medicine (NSAID), such ibuprofen, along with misoprostol is his best recommendation for controlling discomfort during a medical abortion. He advises using an anti-nausea drug, such as the prescription drug metoclopramide, if at all feasible.
Acetaminophen, widely known as Tylenol, is another choice, although NSAIDs are more effective at inhibiting this particular discomfort, according to Colwill.
According to Grossman, using a heating pad, a hot water bottle, or over-the-counter trans-electrical nerve stimulation pads to the lower abdomen can also help “confuse” nearby nerves and reduce discomfort.
He said that it’s critical to know what constitutes “normal” pain and when it might be necessary to get medical attention, particularly when individuals are at home.
For instance, discomfort in the center of the lower abdomen is common, but pain that is higher up or that is limited to one side may indicate a serious disease, such as an ectopic pregnancy, a potentially fatal condition in which a fertilized egg implants outside the uterus.
According to Grossman, people should visit the ER if they have excruciating discomfort on one side of their abdomen or pelvic. They may attempt to speak with a physician over the phone initially if they experience mild to severe discomfort on one side. However, they should visit an emergency room if they have any questions,” he continued.
Although ultrasounds help identify ectopic pregnancies, Grossman noted that “many people have a medication abortion without having an ultrasound and it can even be missed on an ultrasound.”
According to the Food and Drug Administration, medication abortion is not effective for ectopic pregnancies.
According to him, pain that persists for more than 24 hours after the end of a pregnancy, particularly if the patient is also experiencing fever or vomiting, may indicate an infection.
He went on to say that women shouldn’t undervalue the significance of moral support, saying, “Having someone there and feeling supported makes a big difference, too.”
