Many women who end their pregnancies early with the abortion pill are told the pain will be similar to menstrual cramps and are then surprised by how painful it is, a British survey has found.

Medical abortion, commonly called the “abortion pill,” is an effective method of terminating a pregnancy that can occur at home.

In the early stages of pregnancy, at or before 10 weeks, a pregnant person can take a pill called misoprostol, with or without mifepristone, to simulate an early miscarriage.

The Planned Parenthood website describes the process as “kind of like having a really heavy, crampy period.”

But a survey of nearly 1,600 women in England and Wales who had recently had a medical abortion found that comparing the pain to period cramps left them unprepared.

“The pain was much worse than period pain, it was like labor contractions,” wrote one survey respondent. “I’ve given birth three times and the pain really wasn’t too different from the pain, the crampy contractions.”

About half—48.5 percent—of respondents said the pain they experienced was worse than they expected.

When rating the pain out of a maximum of 10, the vast majority — 92 percent — gave their pain at least a 4 out of 10, while 41.5 percent scored it an 8 or more, which is classified as severe.

“Menstrual pain benchmarking has long been used as a way to describe the pain associated with medical abortion, despite the wide variability in menstrual pain experienced,” lead author Hannah McCulloch, a researcher at the British Pregnancy Advisory Service, said in a statement.

“The survey results show that counseling on this aspect of medical abortion needs to be improved.”

“For many respondents, using menstrual pain as a reference point for what to expect was not helpful for managing expectations or consistent with their experience.”

Many women who answered the questionnaire said that the pain was “downplayed” or “sugarcoated” in information leaflets and medical consultations, which often described it as “like a period”, “bad period”, “periodic cramps”. ” or “menstrual cramps”.

One respondent stated that transparency “may deter some women from having an abortion, but I feel that patients have the right to fully understand the risks and benefits.”

Two-thirds of respondents still said they would choose this type of abortion if they needed it in the future, but 13 percent said they would opt for a surgical abortion in clinics instead — mostly citing pain.

On average, those who said they would make a different choice in the future rated their medical abortion 8.5 out of 10 on the pain scale, compared with 6 out of 10 among those who said they would choose it again.

“Women want more detailed, realistic information so they can make treatment decisions and be prepared for a medical abortion if it’s convenient for them,” McCulloch said.

This survey was conducted online among clients of a UK pregnancy advice service between November 2021 and March 2022.

The study was published online Tuesday in the journal Science BMJ Sexual and Reproductive Health.

Link

McCulloch, H., Perro, D., Taghinejadi, N., Whitehouse, KC, Lohr, PA (2024). Expectations and experiences of pain during medical abortion at home: a secondary analysis of a mixed methods survey among patients in England and Wales. BMJ Sex Reprod Health, 0: 1-7. https://doi.org/10.1136/bmjsrh-2024-202533