Is it painful to have an abortion?
Making a decision on having an abortion may get emotionally stressful. Amidst all the dilemma and emotional pain, you may also be bothered by the question ‘is it painful to have an abortion?’. Read on to understand about the various aspects of abortion pain and how it can be managed effectively.
What happens during a medical abortion?
Medical abortion involves taking medicines which will cause the muscles of the uterus to contract vigorously.
The vigorous contraction of the uterus leads to the fetus and other contents of the uterus getting expelled. The medicines used for abortion are known as abortion pills. The process of abortion may take a few hours to days.
There will occur profuse vaginal bleeding in the form of heavy clots. It may take weeks for all the products of conception within the uterus to get emptied.
Medical abortion is possible only upto 9 weeks of pregnancy. Mifepristone tablet is administered orally at the abortion clinic following which the woman is kept under observation for a few hours.
The woman may then go home. She is advised to place misoprostol tablets within her vagina after 24 hours of taking the oral pill.
The process of abortion will start within a few hours of taking the abortion pills and may go on for few days. The woman will be called for a follow-up visit after two weeks during which she will undergo an ultrasound `examination to confirm complete abortion. In case of incomplete abortion with retained products of conception within the uterus, the woman may need a repeat dose of the abortion pill or intervention to clear the uterus.
Cause of pain during a medical abortion
The abdominal cramps will be similar to menstrual cramps but more in severity. The pain may seem to radiate to the lower back and the thighs. The abdominal cramps will be associated with profuse vaginal bleeding and passage of clots.
The doctor will prescribe you strong painkillers to manage the abortion pain. You may also use conservative methods such as a warm pack placed over your abdomen or back. You are advised to be in a comfortable environment through the process of abortion.
You should get adequate rest so as to help you deal with the discomfort. Taking plenty of fluids orally will help prevent dehydration and fall in blood pressure due to the excessive blood loss associated with the abortion process.
Abortion pain may last a few hours to a few days depending on how soon the contents of the uterus get expelled
So the woman may have to continue taking painkillers for a few days from the onset of the abortion process. If the pain is intolerable to the woman despite taking painkillers and experiences symptoms such as giddiness, she may require hospitalization for observation and injectable painkillers.
What happens during a surgical abortion?
Surgical methods are the only option for abortion beyond 9 weeks of pregnancy.Surgical methods of abortion involve inserting an instrument into the opening of the uterine cervix.The instrument is forcefully inserted so as to bring about dilatation of the cervix.
The different types of surgical abortion techniques are outlined breifly below….
1. Manual vacuum aspiration:-
In manual vacuum aspiration after dilating the uterine cervix , the contents of the uterus are aspirated out with the help of negative pressure created by a syringe. The technique of manual vacuum aspiration can be used through 12 weeks of pregnancy. It may be performed as an office procedure at the abortion clinic.
2.Dilatation and evacuation
Dilatation and evacuation involve scooping out the products of conception using an instrument after dilatation of the uterine cervix. This method can be employed through 16 weeks of pregnancy.
The lining of the uterus is also scraped thoroughly so as to remove all the products of conception. It is usually done as a day care procedure.
The instruments used to dilate the cervix or scoop the contents of the uterus may cause laceration or perforation of the uterus. Such complications of surgical abortion are minimal in the hands of experts
Is it painful to have a surgical abortion?
As described already the surgical methods of abortion are preceded by forceful dilatation of the cervical opening. Such forceful dilatation of the cervix will cause pain.
The pain is due to mechanical stretching of the cervix. It is generally perceived as localized pain associated with the procedure.
Apart from the pain due to dilatation of the cervix, scraping of the uterine lining may also trigger pain due to irritation of endometrial nerve fibers.
Manual vacuum aspiration being a short office procedure may be associated with much less pain in comparison to dilatation and evacuation. Besides manual vacuum aspiration does not involve irritating the uterine lining.
Pain due to surgical intervention may persist for a few days post the procedure. So women may have to continue painkiller tablets for a few days after being discharged from the hospital.
If there is unusually intense pain experienced by the woman during a surgical abortion, the possibility of uterine laceration or perforation caused by the instrument used to dilate the cervix should be kept in mind. If there are associated signs like a fall in blood pressure or profuse bleeding during the procedure, complications such as uterine laceration and perforation should be promptly ruled out.
How to manage abortion pain?
The intensity of pain during abortion depends on the method of abortion adopted.
Pain due to medical abortion can be managed with the help of pain killer medicines prescribed by your doctor at the abortion clinic.
You may also find relief through conservative methods of pain relief such as warm compresses to the abdomen and back. Rest will help with relaxation and reduce anxiety associated with the abortion process. If you are unable to manage with the pain of medical abortion at home, you may have to get hospitalized so as to receive painkiller injections or anti-anxiety medicines.
The pain associated with surgical abortion will be managed at the abortion clinic by administering injectable sedatives and analgesics. Manual vacuum aspiration being a short procedure is done under sedation and the woman may go home after a few hours of observation at the abortion clinic. Post-procedure pain can be tackled with the help of strong painkillers prescribed by the doctor
Dilatation and curettage being a longer procedure may require general anesthesia. The woman will be kept under monitoring for 24 hours post the procedure.
In case of complications such as uterine perforation or laceration during a surgical abortion, prompt surgical intervention to treat the uterine injury needs to be done
Painful complications of abortion
Though the complications associated with abortions are minimal in the hands of experts, it is good to be aware of the possible complications which could be distressing. A few known complications of abortion are
A. Infection of the uterus and fallopian tubes called as pelvic inflammatory disease can present as severe pain abdomen, foul-smelling vaginal discharge, and fever. If there is a persistent dull pain in the abdomen following abortion pelvic inflammatory disease should be ruled out. The pelvic inflammatory disease should be treated promptly with broad-spectrum antibiotics to avoid complications such as the spread of infection into the bloodstream
B. If the woman experiences excruciating pain during or after surgical abortion associated with profuse vaginal bleeding, a possible perforation of the uterus should be ruled out.
C. Laceration of the cervix can also result in disproportionate pain and profuse bleeding from the vagina. Cervical laceration should be treated promptly by surgical intervention as it may lead to miscarriages in future pregnancies due to cervical incompetence.
D. Bowel or bladder injury may also occur during a surgical abortion. It may present with severe pain associated with bloody urine or bleeding per rectum. If detected bowel and bladder injuries should be treated surgically.
Is it psychologically painful to have an abortion?
Psychological distress and pain associated with abortion in women may prove the most difficult to identify and treat. Women may suffer a range of emotional problems following an abortion despite being well convinced about the need for abortion
Psychological problems in women post-abortion may include recurrent dreams of the abortion experience, avoidance of emotional attachment, relationship problems, denial, sleep disturbances, feeling of guilt, memory impairment, hostile outbursts, suicidal thoughts or actions, depression etc.
Women may fall into substance abuse. These psychological issues may appear days to years after an abortion experience. It is important to identify such problems early so that prompt therapy can be instituted. Emotional support from the part of the family, friends and healthcare personnel should be extended to the woman following an abortion.
Psychological issues related to abortion can be minimized with adequate pre-abortion and post-abortion counseling. The abortion clinic personnel should be supportive and should be non-judgmental towards the woman seeking an abortion.
The woman should be encouraged to make a well-informed choice so as to suit her best. The decision should be taken of her own free will
Pregnancy after an abortion
If an abortion leads to difficulty in getting pregnant again anytime in the future, it adds to the pain of having had an abortion.
When a woman who has conceived spontaneously in the past has difficulty in getting pregnant it is called secondary infertility. The chances of secondary infertility may increase by about 3 times in women who have had an abortion in the past. Though not always very evident the various causes for secondary infertility in women who have had an abortion may be :
- Blockage of the fallopian tubes due to an infection following an abortion may lead to infertility. The fallopian tube carries the ovum released from the ovaries during a menstrual cycle towards the uterus. The ovum is unable to reach the sperm so as to get fertilized due to the blockage in the fallopian tube.
- Following surgical abortion by scraping the uterine lining, adhesions may form between the walls of the uterine cavity. The adhesions and scarring of the uterus following a surgical abortion may lead to infertility as implantation within the uterus becomes challenging.
It would be more disastrous for the mental and physical health of a woman if she becomes pregnant again soon after an abortion. It is possible for a woman to become fertile again as early as 2 weeks after an abortion, even before the next period. So the woman should be counseled regarding contraception.
Is it painful to have an abortion by traditional methods?
Traditional methods of abortion may not only be painful but also unsafe for the woman. Unsafe methods of abortion may cost a woman her life.
Some of the dangerous native methods of abortion employed are belly flopping and inserting sharp objects into the uterus. In belly flopping the woman deliberately tosses herself onto hard surfaces to cause injury to her pregnant tummy and may prove extremely painful.
If sharp objects are inserted into the uterus, it may lead to injury to the uterus and vagina causing severe pain and profuse life-threatening bleeding.
Is it possible to have a pain free abortion?
Though pain-free abortion is not a routine, we at our government recognized abortion clinic in chennai offers extra analgesia , complete sedation and general anesthesia upon specific request by women and according to the needs of women seeking an abortion. The various options available for pain control during abortion are :
- Intravenous analgesics and sedatives will help in relieving the pain and anxiety associated with the abortion process.
- If the anxiety levels are too much and pain intolerable the woman may require deeper levels of sedation or short duration general anesthesia to help her cope with the procedure.
- The paracervical block which is a form of local anesthesia, prior to dilatation of the cervix during a surgical abortion is an effective method of pain control.
Through this article, we have tried our best to put you at ease prior to your abortion by bringing answers to ‘is it painful to have an abortion?’.
We hope you enjoyed reading this article. Do share the knowledge with your friends and to people in need!.
References:-