PATIENTS undergoing medical abortion at home often feel unprepared for the pain they experience according to new research, with many finding existing counselling inadequate, particularly when pain is described as akin to period pain. Improved, patient-centred pain counselling could enhance the abortion experience and inform method preferences.
This analysis aimed to explore the pain experiences of patients undergoing medical abortion at home and to identify opportunities for improving counselling practices. Conducted by the British Pregnancy Advisory Service, the study included patients who had medical abortions up to 10 weeks’ gestation. Participants completed an online questionnaire in English between November 2021 and March 2022, providing both quantitative responses and free-text comments. The findings offer valuable insights into patients’ expectations and experiences of pain, highlighting gaps in current anticipatory counselling practices.
In total, 1596 out of 11,906 invited participants (13.4%) completed the questionnaire, with all providing at least one free-text comment. Reflexive thematic analysis of qualitative responses revealed three primary themes: pain severity, quality, and comparisons to other types of reproductive pain. While some patients found the pain tolerable, others described it as far more intense than expected, with the commonly used comparison to period pain being deemed unhelpful or misleading. Quantitative data showed that pain experiences influenced method preferences, with many patients favouring improved counselling that incorporates detailed, realistic descriptions of pain and accounts from individuals who have undergone medical abortion at home. Statistical analysis highlighted significant associations between perceived adequacy of counselling and overall satisfaction with the abortion experience.
The findings emphasise the importance of patient-centred approaches in abortion care. Healthcare providers should consider incorporating diverse, accessible descriptions of pain into their counselling materials and prioritise setting realistic expectations. This may help patients make more informed decisions about their preferred method of abortion and improve their overall experience. Future research should focus on developing and evaluating enhanced counselling materials to ensure they address patients’ needs effectively, thereby contributing to improved clinical outcomes and patient satisfaction.
Abigail Craig, EMJ
Reference
McCullock H et al. Expectations and experiences of pain during medical abortion at home: a secondary, mixed-methods analysis of a patient survey in England and Wales. BMJ Sex Reprod Health. 2024. DOI: 10.1136/bmjsrh-2024-202533.
[AC1]https://www.emjreviews.com/reproductive-health/news/administering-misoprostol-at-home-improves-abortion-efficiency/
