Pain associated with medical abortion is the consequence of the contraction of the muscular layer of the uterus. Mifepristone is the drug taken in the first stage of medical abortion has little effect on the tone of the uterus, so it almost never causes any pain while taking it.
Misoprostol or also known as Cytotec is the drug for the second stage of the procedure and intensively stimulates uterine contractions, which is its main contribution to the abortion effect. Due to contractions, the ovum is expelled from the uterus. Of course, this process has the opposite effect – those same cramping pains.
Pain in the lower abdomen appears between 30 minutes and 4 hours after taking Misoprostol. Painful sensations can be of very different intensity – from barely perceptible to unbearable. The nature of pain can also be different: cramping, pulling, pressing. If the patient is experiencing acute, cutting pain, this may indicate ectopic pregnancy. In this case, you must immediately seek medical assistance in the hospital.
The intensity of pain during medical abortion is directly proportional to the duration of pregnancy – the longer the abortion, the stronger the pain. In addition, the level of painful sensations largely depends on the individual pain threshold of a woman. Therefore, when planning a medical abortion it’s important to calculate the duration of pregnancy.
The duration of pain can be from several hours to days, but on average they last 3-4 hours. If the pain continues for a long time, it is associated with a relatively long gestational age. In the later stages of the uterus it’s harder to expel the ovum. When this process is completed, the pain usually subsides.
In 2006, a case study was conducted, during which women who resorted to the procedure of medical abortion were asked to rate their pain on a 10-point scale. Score “1 point” meant light pain, “10 points” – intolerable pain. The results were as follows:
- moderate pain (3-5 points) – 25%
- very strong and severe pain (6-8 points) – 40%
- intolerable pain (9-10 points) – 10%.
Based on the results of the study, about half of the patients after abortion do not need pain management drugs. The other half should be given special analgesics.
Ibuprofen is the generally the most effective painkiller for cramps.