McCulloch Hannah, Perro Danielle, Taghinejadi Neda, Whitehouse Katherine C, Lohr Patricia A
Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK
Centre for Reproductive Research & Communication, British Pregnancy Advisory Service, London, UK.
BMJ Sex Reprod Health. 2025 Apr 9;51(2):137-143. doi: 10.1136/bmjsrh-2024-202533.
To explore experiences of pain during medical abortion and provide patient-centred recommendations for improving abortion experience and pain counselling.
We invited patients of British Pregnancy Advisory Service who underwent medical abortion up to 10 weeks' gestation to participate in an online, English language questionnaire from November 2021 to March 2022. Participants answered questions about pain, method preference, abortion experience, advice, and how they would describe pain experienced to a friend. In this secondary analysis, we analysed free-text responses using reflexive thematic analysis techniques. We used descriptive statistics and parametric tests to analyse quantitative responses.
Of 11 906 patients invited to participate, 1596 (13.4%) completed the questionnaire, including at least one free-text comment. Participants used a range of descriptors for medical abortion pain across three broad themes: pain severity, pain quality and comparisons to other reproductive pain. Some found the commonly used analogy to period pain misleading. Many felt unprepared for the level of pain they experienced, which they attributed to provider comparisons to period pain, as well as a lack of detailed, realistic anticipatory pain counselling. Qualitative and quantitative results suggest pain experiences impact method preference. Participants recommended better counselling for pain and abortion preparation, including first-hand accounts of medical abortion at home and a wide and accessible range of descriptions of pain.
Abortion providers should use patient-centred recommendations to better prepare patients for pain during medical abortion. Setting realistic expectations can improve abortion experience and support informed method choice. Further research is needed to develop and test patient-centred counselling materials.
探讨药物流产期间的疼痛体验，并提供以患者为中心的建议，以改善流产体验和疼痛咨询服务。
我们邀请了妊娠10周内接受药物流产的英国妊娠咨询服务机构的患者，于2021年11月至2022年3月参加一项在线英语问卷调查。参与者回答了有关疼痛、方法偏好、流产体验、建议以及他们会如何向朋友描述所经历的疼痛等问题。在这项二次分析中，我们使用反思性主题分析技术分析了自由文本回复。我们使用描述性统计和参数检验来分析定量回复。
在受邀参与的11906名患者中，1596名（13.4%）完成了问卷，其中至少包含一条自由文本评论。参与者在三个广泛主题中使用了一系列描述词来形容药物流产疼痛：疼痛严重程度、疼痛性质以及与其他生殖疼痛的比较。一些人发现将其与痛经进行类比具有误导性。许多人对自己所经历的疼痛程度毫无准备，他们将此归因于医疗服务提供者将其与痛经进行比较，以及缺乏详细、现实的预期疼痛咨询。定性和定量结果表明，疼痛体验会影响方法偏好。参与者建议提供更好的疼痛和流产准备咨询，包括在家进行药物流产的第一手描述以及广泛且易于获取的疼痛描述。
流产服务提供者应以患者为中心提供建议，以便更好地让患者为药物流产期间的疼痛做好准备。设定现实的期望可以改善流产体验并支持明智的方法选择。需要进一步开展研究来开发和测试以患者为中心的咨询材料。
