Abortion AMA: Does An Abortion Hurt?
Welcome to Bustle's Abortion AMA column, where reproductive rights advocate and Romper editor Danielle Campoamor will speak to experts and medical professionals to answer people's questions about abortion in a way that is educational, unvarnished, and judgement free. Ask us anything.
As a woman with endometriosis, I'm no stranger to cramping or even debilitating pain localized in my lower abdomen. So when I found myself unexpectedly pregnant almost eight years ago, the possibility of an abortion being painful didn't keep me from making the personal and medical decision I knew was best for me. I definitely did want a sense of what the procedure would feel like, though, so I could prepare as best I could. Like many women about to terminate a pregnancy, I wanted to know — does an abortion hurt?
To answer that question, first let's look at the most recent research. An article to be published in an upcoming issue of the journal Contraception looked at a wide range of studies on pain management during surgical abortion procedures and found that the majority of women do not report experiencing "severe" pain during abortions in the first trimester. While many women (46 percent, in the highest case) experience "moderate" pain during a surgical abortion under local anesthesia, much of that pain is similar to menstrual cramping and can be reduced through a diverse range of doctor-supervised methods.
"Many women describe the sensations associated with an abortion as feeling like strong period cramps," says Dr. Emily Cohen, a family physician and fellow with Physicians for Reproductive Health, a group of doctors who advocate for reproductive rights. She was not involved in the study. "But keep in mind, everybody is different, and every experience is different. If you are considering abortion and you are concerned about pain, ask your provider about pain management options," Cohen tells Bustle.
If you're seeking a surgical abortion — often times a vacuum aspiration, administered in a clinic by a licensed physician who numbs and dilates your cervix, then uses suction to empty the contents — your options for preventing pain include local anesthesia, minimal sedation, or moderate sedation. If you are seeking a medical abortion — a termination induced by two oral medications, one taken in a doctor's office or clinic and another taken six to 48 hours later — a 2009 study published in the journal Fertility and Sterility found that ibuprofen is an effective pain medication.
Those are great general guidelines, but since everyone's threshold for pain varies, Bustle talked to other women who've had abortions about their procedures and how much physical pain (if any) they experienced.
Valerie From Seattle, Washington
"My abortion happened at the juncture between the first and second trimesters, and although it was a short outpatient procedure, my Canadian-trained doctor opted for conscious sedation like that used during a colonoscopy. So, no pain. I remember, as I was regaining my senses, seeing a small jar with blood in it, the remains of my gestational sac and placenta, but I don’t remember physical discomfort. I must have been sore in the days that followed, but everything else I was processing far outweighed any physical discomfort."
Danielle From Portland, Oregon
"I had a D&C to terminate a pregnancy at 10 weeks. Before the procedure, I was given laughing gas, so the only sensation I experienced was a slight tugging in my uterus. Afterwards, I had cramping that lasted for about two days, but it wasn’t more painful than what I feel during a heavy period. After my abortion I went on to have a healthy pregnancy and gave birth to a beautiful baby girl, now three years old."
Mallory From Cleveland Heights, Ohio
"My pregnancy was around nine weeks, and I opted for a standard surgical abortion. I had conscious sedation during the procedure, so I was a little out of it, but I do remember feeling sharp pains for a few minutes. By the time I was dressed and in the recovery room, I was only having dull cramps that felt like moderate period cramps. Surprisingly, I didn't have much cramping at all once I got home. The only discomfort I had was in my cervix and vaginal wall; it felt like I had a paper cut for a few days. I got a rash from the adhesive on the bandaid the clinic put on my IV site and that was the biggest issue with my recovery.
I had an IUD (intrauterine device that prevents pregnancy) inserted a month after my abortion, and I remember being surprised that the IUD was much more painful."
Daniela From Washington D.C.
"The physical experience of my abortion was that I was given medications that would allow me to feel relaxed and intravenous medication to aid any pain or discomfort management. The medications ... were great because my pelvic floor and glutes were relaxed throughout the procedure. Regardless of the medication used or the lidocaine used to soften the cervix for dilation, I still felt manageable cramps during both the dilation and procedure.
After my abortion, I asked to have a hormonal IUD inserted. I recall the cramping from the IUD more clearly than the discomfort of the dilation and abortion: it felt like a short but consecutive wave of cramps. My procedure lasted less than three minutes — softening of the cervix, dilation, aspiration — although, at the time, I felt time moving very slowly. My adrenaline was still high, my body was hyper-alert, [and] my focus was on the possible experience of pain, which never came in the form of pain but in the form of cramps and discomfort.
I would say my strongest cramp came from the insertion of the IUD, more so than from the abortion itself."
Holly From Cleveland, Ohio
"I had a surgical aspiration at seven weeks with conscious sedation. During the procedure, it mostly felt like intense pressure; like my dachshund was sitting right on top of my pelvis. It was rather quick. Most of the pain I experienced was after the procedure, but the pain I experienced while I was recovering felt very much similar to a really bad period, but not the worst I've ever had. (I have polycystic ovary syndrome, also known as PCOS.) I know many people have different experiences with their abortions in relations to pain. For me, my pain tolerance is pretty high, and I'm used to the pain I experienced."
My own abortion experience wasn't particularly painful. It was as if I was experiencing five days of cramps all at once and for only a few moments. There was some lingering discomfort, but it didn't last beyond a few days. I had a surgical abortion, so my cervix was numbed, then dilated, then a plastic tube was inserted into my uterus to suck out the contents. I was administered a light sedative prior to the procedure to minimize cramping and so I could relax while remaining conscious. After the abortion was over — it took about seven minutes from start to finish — I was given a heating pad, antibiotics to help prevent infection, and some crackers and juice. I was in the recovery room for about 20 minutes before I felt ready to get up, walk out of the clinic, and go home.
I was never in an immense amount of pain, and I was never more sure of my decision. And even at my most uncomfortable, I was comforted by the fact that I knew I was making the best choice for myself, my body, and my future.
Have questions about abortion? You can email them safely and anonymously to Abortion AMA at email@example.com, and we'll answer them. Together.