Pain during medical abortion: predicting factors from gynecologic history and medical staff evaluation of severity

Abstract

Background: We studied whether it is possible to predict severity of pain during medical abortion. We also studied how well medical staff recognizes the pain perceived by these women.

Study design: Fifty-four women (mean age 26 years, range 18-42 years) undergoing medical abortion before the 64th day of gestation (mean 47 days, range 32-63 days) were asked to estimate their menstrual pain and the pain perceived during medical abortion by visual analogue scale (VAS). Both the intensity and unpleasantness of pain were evaluated separately. The nurses observing the women undergoing medical abortion at the outpatient clinic were asked to estimate by VAS scores their perception of the intensity of pain of the women.

Results: Higher age (magnitude r = -0.30; unpleasantness r = -0.28), increasing number of previous pregnancies (r = -0.34; r = -0.36) and deliveries (r = -0.57; r = -0.60) correlated negatively and advanced gestational length (r = 0.31; r = 0.32) positively with magnitude and unpleasantness of pain evoked by abortion. Twenty-eight (51.8%) of the women were nulliparous. Pain during medical abortion correlates positively (magnitude r = 0.34; unpleasantness r = .0.41) with pain during menstruation. There was no difference between either the intensity or unpleasantness of pain during menstruation and pain during medical abortion. Medical staff accurately assessed the pain women experienced during medication abortion (magnitude r = 0.83; unpleasantness r = 0.79).

Conclusion: Pain during medical abortion correlates with the pain during menstruation. This finding makes counseling of women choosing medical abortion easier and helps in planning the pain relief needed.