Pain of first-trimester abortion: its quantification and relations with other variables

Among 2,299 patients on whom first-trimester abortions were performed after administration of local anesthesia, 97 per cent reported experiencing some degree of pain. Independent ratings of the pain severity were obtained from the patients and also from the doctors and counselors who observed them. Although the rating procedures used by patients from those used by doctors and counselors, the three sources agreed significantly in evaluating pain levels of individual patients. Data from all three sources indicated that pain produced during the abortion procedure tended to be minor in severity. The ranking of relative painfulness of the eight stages of the aborton procedure based on average ratings obtained from doctors was nearly identical to that based on average ratings obtained from counselors. (Patients did not rate the separate stages.) On average, the patients rated the pain as being less than earache or toothache, but more than headache or bachache. The youngest patients experienced the most pain, and the oldest experienced the least. Both gestational age and cervical dilatation were related to pain in a curvilinear fashion, i.e., for both variables, patients in extreme categories experienced more pain than those in intermediate categories. Preprocedure fearfulness was positively related to intraoperative pain. No support was found for the expectation that oral administration of 5 mg. of diazepam reduces pain during this procedure.