Dzuba Ilana G, Chandrasekaran Sruthi, Fix Laura, Blanchard Kelly, King Erin
Consultant, New York, NY, USA.
Ibis Reproductive Health, Cambridge, Massachusetts, USA.
Womens Health Rep (New Rochelle). 2022 May 12;3(1):533-542. doi: 10.1089/whr.2021.0103. eCollection 2022.
There is limited documentation about pain and side effects associated with dilation and evacuation (D&E) abortion, yet, pain and side effects are important factors that can affect a client's abortion experience. In 2016, Hope Clinic for Women, an independent abortion clinic in Illinois, altered its cervical preparation protocols before D&E to reduce the total time of the abortion process and improve the client experience. This analysis addresses the gap in data on client experience of abortion in the later second trimester by evaluating pain, side effects, and acceptability by gestational age.
Abortion clients obtaining services at the clinic between March 2017 and June 2018 were eligible to participate if they had viable singleton pregnancies of 16-23.6 weeks' gestation, spoke English, and were at least 18 years old. Eligible participants completed a two-part survey about their abortion experience.
We found that respondents seeking abortion care at later gestations in the second trimester were more likely to report pain during their abortions. We did not find any association between side effects and gestational age.
Although most respondents were prepared for the pain they experienced, some reported experiencing more pain than they expected, and more effective pain relief was commonly reported as a way to improve the service. More research on patient experiences of later abortion is needed, particularly on experiences of pain and options for pain management.
关于扩张与清除（D&E）堕胎相关的疼痛和副作用的文献资料有限，然而，疼痛和副作用是会影响患者堕胎体验的重要因素。2016年，伊利诺伊州一家独立堕胎诊所——女性希望诊所，在D&E堕胎前改变了宫颈准备方案，以缩短堕胎过程的总时间并改善患者体验。本分析通过评估疼痛、副作用以及按孕周划分的可接受性，填补了孕中期后期堕胎患者体验数据方面的空白。
2017年3月至2018年6月期间在该诊所接受服务的堕胎患者，若怀有16 - 23.6周可存活的单胎妊娠、会说英语且年满18岁，则有资格参与。符合条件的参与者完成了一份关于其堕胎体验的两部分调查问卷。
我们发现，在孕中期后期寻求堕胎护理的受访者在堕胎过程中更有可能报告疼痛。我们未发现副作用与孕周之间存在任何关联。
尽管大多数受访者对所经历的疼痛有所准备，但一些人报告称实际疼痛程度超过预期，且普遍认为更有效的疼痛缓解措施是改善服务的一种方式。需要对孕中期后期堕胎的患者体验进行更多研究，尤其是关于疼痛体验和疼痛管理选项的研究。
