Pain in a surgical abortion is different for everyone. Because pain can be a whole-body experience that affects mind and body, we use a variety of pain management techniques to provide the highest degree of comfort for every patient.
Even before entering the operating room, our patients’ abortion journey has already begun. Each of us at the clinic wishes our patients were spared the challenges that may have brought them into our care, but we know we play an important role in helping them achieve relief and empowerment in their individual situations.
We’re highly sensitive to the fact that every patient’s story and experience with abortion are unique. To ensure our patients come through their surgical abortion comfortably, without trauma or suffering, we take every measure possible to control pain. Here, we help you understand pain and what we do to manage it.
What is pain?
Pain is a signal transmitted by many layers of our bodies. It connects the tissues of our skin and organs, travelling through an endless network of wiry nerves, up the elevator of our spine and into the deep recesses of our mind. It’s here where pain connects an experience to past (and future) negative memories and emotions.
Just as pain can occur throughout our bodies, our approach to pain management is both internal and external, treating it at every layer of the body.
Pain in the mind: addressing fear
The mind is the most powerful place in the body for pain. The brain can amplify a negative physical sensation ⎯ turning touch into pain, for example ⎯ or lessen and even erase painful ones.
Diminishing fear is one of the first and most important things we do to help a patient manage pain:
Before the procedure, we familiarize patients on what they can expect to experience during the abortion, through an instructional video and pre-operative counselling.
Patients have the option to proceed with their procedure the same day, or return on another day when they feel more prepared.
During the procedure, a nurse stays with the patient to explain what she will feel and coaches her to use breathing for self-calming. Fully attuned to the patient’s needs, the nurse directs the process to suit her as much as is safely possible, so she feels in control of what is happening to her body.
If needed, we also administer Midazolam, a medication which helps decrease feelings of fear, and for some patients, diminishes the memory of the procedure.
Pain management in the tissues
Next, we use Lidocaine, a local anesthetic used in dental freezing, to numb both the cervix and uterus. Administered by injection, Lidocaine works to instantly block pain nerves from transmitting signals to the brain. After a few seconds of initial sharpness and slight burning sensation from the injection, the cervix and uterus become numb to pain over the next one to four hours, depending on the person. Patients will still experience a sense of pressure or touch, however the feeling of pain will be absent or very mild.
Controlling pain in the spine and brain
We also use narcotics ⎯ medications which act at specific nerves all over our bodies ⎯ to decrease both physical and emotional pain. We administer Fentanyl, which takes effect within minutes and leaves the body very quickly (after about 45 minutes), making it ideal for the five- to ten-minute abortion procedure.
Fentanyl side effects Fentanyl can cause nausea, vomiting and constipation. We use the minimum effective dose in order to avoid these side effects as much as possible. By the time patients are discharged from the clinic, almost all of the Fentanyl has left their bodies. Because trace amounts of medication may still be in their bodies, patients are prohibited from driving for 24 hours after the dose was administered. This trace amount of Fentanyl, however, is safe during breastfeeding.
When used in controlled, medical settings, narcotics are extremely unlikely to cause addiction or overdose. During a quick and painful surgical procedure, narcotics allow patients to emerge from it without suffering.
Using all of these pain management techniques, we find that most patients undergoing first trimester procedures experience anywhere from no pain to mild cramping, similar to that of a regular period.
For those who do experience some pain, we do our best to make it as minimal and short-lived as possible. It’s our goal to help our patients heal quickly, and return to their lives healthy and whole.
Thinking about abortion?
Contact us to see how we can support you.