More than ‘cramps’: Study finds pain from abortion pills worse than women expected

Nearly half of women who took abortion pills to end their pregnancies said the experience was more painful than they had been led to believe, according to a newly published survey.

A study conducted by the British Pregnancy Advisory Service of 1,596 women from England and Wales found that 48.5% said the pain was greater than expected, with 92% giving it a score of at least 4 on a scale of 1 to 10.

Of those, 41.5%, scored their pain at 8, 9 or 10, according to the study published Tuesday in BMJ Sexual Health & Reproductive Health.

“While two thirds (1,047) of respondents said they would choose a medical abortion if needed in future, around one in eight (13%; 202) said they would have a surgical abortion,” said the British Medical Journal summary in MedicalXpress. “Most of them (83%; 167) cited pain as a factor in this decision.”

Abortion providers often compare the pain of taking abortion pills with period cramps, but that description “leaves many women unprepared for the intensity of the pain they experience,” said the journal.

Planned Parenthood, for example, says on its website that undergoing an at-home abortion using the pills is “like having a really heavy, crampy period.”

The study concluded that patients want “detailed, realistic anticipatory pain counseling as well as general preparatory advice, including first-hand experiences which reference a wide and accessible range of descriptions of pain.”

Lead author Hannah McCulloch said that “counseling on this aspect of medical abortion needs to improve.”

“For many respondents, using period pain as a reference point for what to expect was not helpful for managing expectations, or in line with their experiences,” she said in a statement.

Abby Johnson, a former Planned Parenthood clinic director and founder of the pro-life group And Then There Were None, said that the survey shows that women “aren’t being told the truth about what happens during a medication abortion.”

“I hope they will realize that they were never told the truth about their medication abortion and that, unfortunately, their desperation was seen as a moneymaker by the abortion industry,” Ms. Johnson said.

“That’s certainly how I felt when I was given the abortion pills and sent on my merry way, only to find out later the absolute horror of what a medication abortion looked like,” she said.

One of the survey respondents said the abortion-pill experience more closely resembled giving birth than her monthly cycle.

“Pain was so much stronger than period pain, it was like having contractions in labor,” she said. “I’ve given birth three times and the pain really wasn’t too much different from that pain, the cramping contraction pain.”

Some of the women said that the information they received ahead of time was “washed over,” “downplayed” and “sugar-coated,” while others said the experience was no more painful than “period cramps” or a “bad period.”

One respondent said that being more candid “might put some women off from abortion, however, I feel that patients have a right to fully understand the risks and benefits. This should be made absolutely transparent; shared and informed decision making is essential.”

The two-pill abortion protocol of mifepristone and misoprostol has become the most common method for women in England and Wales, as well as the U.S., for terminating pregnancies up to 10 weeks’ gestation.

The study was conducted among BPAS clients who filled out an online questionnaire between November 2021 and March 2022. Most of them were between the ages of 20 and 39.