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Purcell, Carrie; Newton, Victoria Louise; Bloomer, Fiona and Hoggart, Lesley
(2024).
DOI: https://doi.org/10.1136/bmjsrh-2023-202198
Abstract
Objective
To explore experiences of pain in the context of early medication abortion in the UK and to guide best practice around anticipatory guidance on pain.
Methods
From late 2020 to early 2021, we recruited people from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and data analysed thematically using Nvivo12.
Results
Focused coding and thematic analysis addressed accounts of pain, which were prominent in many interviews. We constructed the following sub-themes: expected pain is manageable for some; the problem with unexpected pain; pain (co)produces fear; problematising ‘period-like pain’. The key issue which our analysis draws out is that, while early medication abortion (EMA) pain experience might vary, for some it may be much worse than anticipated. Moreover, the common trope of likening it to ‘period pain’ can be misleading and a source of additional uncertainty at a potentially already challenging time.
Conclusions
For some, pain experienced in EMA will be severe and/or worse than expected. Insufficient preparation for pain can result in extremely negative experiences of EMA. Alongside development of improved analgesia, improvements should be made to anticipatory guidance on pain, particularly for those self-manging EMA at home. Framings of ‘period-like pain’ do not clarify expectations and should be avoided.
Key messages
WHAT IS ALREADY KNOWN ON THIS TOPIC
• Pain in early medication abortion is a known issue which potentially limits acceptability and has particular implications for home self-management.
WHAT THIS STUDY ADDS
• Our analysis highlights the nuances and variability of EMA pain experiences, including where pain contributes to an extremely unpleasant overall experience.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
• Our findings suggest that the ‘period-like pain’ analogy should be avoided, and that those seeking EMA should effectively be made aware of the spectrum of possible pain experiences.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)
