There is general agreement among medical experts that abortion can cause pain in women, and that the methods used to treat this pain are not always sufficient. Between 78 and 97 per cent of women say they experience at least moderate pain during a surgical abortion.1 Pain may vary by procedure, with suction evacuation apparently the most painful.2
Many common techniques for pain reduction may not actually work. While most studies find that conscious sedation effectively reduces pain, some disagree.3 Another common method of pain reduction is paracervical block, but one review found that there is surprisingly insufficient evidence of its effectiveness.4
The physical causes of pain during abortion are fairly well known and vary by method. Suction evacuation involves pain due to cervical dilatation and uterine contractions.5 Pain during dilation and curettage occurs during injection of the cervical block, cervical dilation, and suction aspiration.6 Pain is also associated with pre-operative anxiety.7
Pain during abortion may be linked to psychological problems after abortion. One study found that patients receiving local anaesthesia reported more pain and more depression, anxiety, and post-traumatic stress symptoms than patients receiving intravenous sedation.
Despite this evidence, women are often uninformed about abortion pain. Many women are mistakenly told that the pain will be similar to menstrual cramps.8 In addition, physicians often underestimate the amount of pain experienced.9