• Posted December 20, 2024

Some Abortion Pill Users Surprised By Pain, Study Says

Abortion pills are safe and effective, but some pain will be part of the process for most women.

However, many women are surprised by exactly how much pain is involved in a medication abortion, a new study says.

They’re frequently told that the pain is akin to period cramps, but for many that simply isn’t so.

“Benchmarking against period pain has long been used as a way to describe the pain associated with medical abortion, despite the wide variability of period pain experienced,” Hannah McCulloch, a sexual and reproductive health researcher with the British Pregnancy Advisory Service in London, England said in a news release.

But “for many respondents, using period pain as a reference point for what to expect was not helpful for managing expectations, or in line with their experiences,” McCulloch added.

In fact, the pain is so intense for some women that they told researchers they might have chosen a surgical abortion if they’d known, according to results published in the journal BMJ Sexual & Reproductive Health.

“Pain was so much stronger than period pain, it was like having contractions in labor,” one study participant said. “I've given birth three times and the pain really wasn't too much different from that pain, the cramping contraction pain.”

Another participant described her pain “like someone squeezing my stomach muscles, like my insides were being twisted.”

For the study, researchers analyzed responses from nearly 1,600 British women surveyed following a medication abortion. The surveys occurred between Nov. 2021 and March 2022.

The women were asked about the pain they experienced, and how they’d describe it to a friend.

About half (49%) said the pain they experienced was more than expected, results show.

Nine out of 10 women (92%) said their pain was at least 4 on a scale from 1 to 10, and about 42% gave their pain a score between 8 and 10, researchers said.

As the numbers and testimonials show, heavy pain was not the experience all women had.

“The pain felt like my normal period pains but just a little bit worse,” one participant said. “Nothing extreme, but just that bit worse.”

But telling women to expect pain akin to period cramps leaves them unprepared for just how painful a medication abortion can become, researchers found.

The women surveyed said that the information they got from consultations or leaflets “washed over”, “down- played” or “sugar-coated” the pain to be expected in a medication abortion.

“The amount of pain you could go through is completely played down,” one woman said. “I understand they probably don't want to scare many women, but I'd rather know how bad the pain can get.”

Despite the pain, about two-thirds of the women said they’d still choose the abortion pill if needed in the future.

But about one in eight (13%) said they would rather have a surgical abortion. Of those women, more than 80% cited pain as a factor in this decision.

Those who said they’d opt for a surgical abortion reported an average maximum pain score of 8.5, compared to a score of around 6 for those who said they’d use the abortion pill again, results show.

“[Being transparent] might put some women off from abortion,” one woman said. “However, I feel that patients have a right to fully understand the risks and benefits. This should be made absolutely transparent; shared and informed decision making is essential.”

These findings already have prompted the British Pregnancy Advisory Service to change the way they advise patients prior to a medication abortion, researchers noted

“Women want more detailed, realistic information to make choices about treatment and to be prepared for (medication) abortion if that is their preference,” McCulloch said. “This evaluation led us at BPAS to create new patient materials and provide additional staff training, which we are currently in the process of evaluating.”

More information

Planned Parenthood has more about the abortion pill.

SOURCE: BMJ, news release, Dec. 17, 2024