Foregrounding pain in self-managed early medication abortion: a qualitative study.

Area of Science:

• Reproductive Health
• Pain Management
• Patient Experience

Background:

• Early medical abortion (EMA) is a common procedure.
• Understanding patient experiences of pain is vital for improving care.
• The COVID-19 pandemic impacted healthcare access and delivery.

Purpose of the Study:

• To explore pain experiences during EMA in the UK.
• To inform best practices for anticipatory pain guidance.
• To identify areas for improving patient preparation and support.

Main Methods:

• Conducted in-depth, semi-structured telephone interviews with individuals who underwent EMA in the UK.
• Utilized a storytelling approach to gather rich qualitative data.
• Employed thematic analysis using NVivo 12 software for data interpretation.

Main Results:

• Pain experiences during EMA varied significantly among participants.
• Unexpected pain was a significant source of distress and fear.
• Describing EMA pain as 'period-like' was often misleading and increased uncertainty.
• For some, pain was much worse than anticipated, leading to negative experiences.

Conclusions:

• Anticipatory guidance on EMA pain needs improvement, especially for home-based self-management.
• Avoiding the 'period-like pain' analogy is recommended to set realistic expectations.
• Enhanced pain preparation and improved analgesia are necessary to mitigate severe pain experiences and negative outcomes.