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Do Abortions Hurt? What To Expect When Taking The Pill Or Undergoing In-Office Surgery

Does it hurt?
The short answer is that it’s different for everyone. No one can tell you exactly how it will feel.
Some people compare the process to menstrual cramps, while others report more discomfort.
Whether it hurts depends on several unique factors, such as:

  • your overall health, including underlying medical conditions
  • how far along the pregnancy is
  • your general pain tolerance
  • the type of abortion you have
  • your emotions and stress level

Keep reading for more on what to expect of a medical or surgical abortion, as well as questions to ask your healthcare provider.

What does it feel like to have a medical abortion?
Your provider will administer two drugs: oral mifepristone (Mifepred) and misoprostol (Cytotec).
Although misoprostol is usually taken orally, some take it vaginally, buccally (between your teeth and cheek), or sublingually (under the tongue).
These drugs block pregnancy hormones and also cause uterine contractions to push the embryo out. It can take four or five hours for tissue to be expelled.
This process causes vaginal bleeding somewhat heavier than a normal period. That means you’ll need a good supply of pads.
You’ll also pass some rather large clots. This will slow down after a few days, but you may continue to bleed or spot for a couple of weeks.
You may also experience:

  • mild to severe cramping
  • headache
  • breast tenderness
  • upset stomach
  • nausea
  • vomiting
  • low-grade fever
  • chills
  • diarrhea
  • dizziness
  • fatigue

These side effects usually clear up in a day or two.
Vaginal, buccal, or sublingual medications may have fewer side effects than oral medications.
What your healthcare provider can do to minimize pain during the process
Talk to your provider about taking an over-the-counter (OTC) medication beforehand, such as ibuprofen. This may help reduce your risk for cramping.
If you tend to get nauseous, you should also ask about anti-nausea medication. Your provider may advise you to take this beforehand, or wait until you begin experiencing symptoms.
They may also prescribe stronger pain killers or other medication to help relieve discomfort.
What you can do after to alleviate pain and related symptoms
Ibuprofen is more effective than acetaminophen at relieving pain following medical abortion. However, you shouldn’t take aspirin, because it can increase bleeding.
You may also find it helpful to:

  • Try and schedule the process on a day you can stay at home.
  • Wear loose clothing for the first couple of days.
  • Use a heating pad or hot water bottle on your abdomen to relieve cramping.
  • Use pillows to prop yourself up in a comfortable position.
  • Try deep breathing exercises.
  • Take a long, warm shower.
  • Get someone to rub your back.

What does it feel like to have a surgical abortion?
Surgical abortion starts out similarly to a pelvic exam. Your healthcare provider will ask you to rest your feet in the table’s stirrups and use a speculum to inspect your vagina and cervix.
After that, they’ll apply numbing medication and dilate your cervix. Then, they’ll insert a small, flexible tube into your uterus. The tube is attached to a gentle suction device, which is used to empty the contents of your uterus.
Your doctor may also gently scrape the inside of your uterus with a small, loop-shaped tool. This is called ‘curettage.’ This will ensure that your uterus is completely empty.
If the pregnancy is more than 15 weeks along, your provider will use a combination of suction, curettage, and extraction with forceps to completely empty the uterus.
You may start to feel uterine cramping and bleeding right away. This may continue for several weeks.
Other potential side effects include:

  • nausea
  • vomiting
  • fever
  • chills
  • dizziness
  • heavy bleeding

What your healthcare provider can do to minimize pain during the process
Most providers will administer local anesthesia before performing a surgical abortion. You may also be instructed to take pain medication prior.
You can request to be sedated. Your provider can give you a mild dose of general anesthesia (“twilight sedation”), or an oral sedative to help block pain and reduce anxiety.
You’ll remain conscious during the procedure, but you won’t remember what happened. You’ll feel “out of it” until the anesthesia wears off, so you’ll need someone to drive you home afterward.
What you can do after to alleviate pain and related symptoms
You can take OTC medications like ibuprofen to help ease your symptoms. Avoid aspirin, as it may increase post-abortion bleeding.
You can also apply a heating pad or hot water bottle to your abdomen to ease cramping. Wearing loose clothing for the first few days can also minimize the pressure on your abdomen.

Does the embryo feel any pain?
To feel pain, humans must be able to transmit signals from peripheral sensory nerves to the brain. We also need certain brain structures to process those signals.
According to the American College of Obstetricians and Gynecologists, rigorous scientific studies have found that the connections necessary to process pain signals don’t develop until at least the 24th week of gestation.
Current laws don’t allow for abortions performed after this point, as the pregnancy is considered viable.

Are there any other physical risks to consider?
Any medical procedure comes with some risk.
For abortion, the risks include:

  • infection
  • prolonged or severe bleeding
  • incomplete medical abortion requiring further intervention
  • unwanted pregnancy if a medical abortion doesn’t work

In 2012, a large-scale study concluded that legal induced abortion is safer and has lower morbidity than that associated with childbirth.
An uncomplicated abortion won’t affect your ability to get pregnant again. In fact, pregnancy can happen right away.

Are emotional side effects possible?
The emotional aspects of having an abortion are different for everyone. A lot depends on your reasons for having one, what stressors may have been involved, and whether you have a solid system of support.
You may feel relieved, grateful, and quickly ready to move on. Or you may feel sadness, guilt, or a sense of loss. You might even have a mixture of all these feelings. There isn’t a right or wrong way to feel.
If you’re experiencing negative emotions and feel that they’re interfering with your daily life, you may find it helpful to consult a healthcare professional. They can help you work through your emotions in a healthy way.

Talk to a healthcare provider
Having an abortion and deciding which type are big decisions, so it’s important to get the information you need up front.
Make sure you discuss the following with your healthcare provider:

  • any underlying medical conditions you have
  • medical versus surgical abortion: how they work, and the pros and cons
  • what you need to do to prepare
  • recovery time
  • potential side effects and what to do about them
  • symptoms that mean you should call your doctor
  • what you need to know about birth control after abortion
  • alternative options for the pregnancy, including adoption

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Katie Haller

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