Pain during abortion – exploratory qualitative study (PANDA-Q1)
Research type
Research Study
Full title
PAiN During Abortion – Exploratory Qualitative Study (PANDA-Q1)
IRAS ID
314913
Contact name
John J Reynolds-Wright
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
0 years, 3 months, 1 days
Research summary
Summary of Research
This is a qualitative study exploring the experience of pain during medical abortion treatment. This means that information about thoughts and feelings will be gathered using interviews, rather than using numbers or statistics. This is important for the subject matter as pain is a subjective, varied and individual experience.
The purpose of the study is to better understand pain during medical abortion so that in the longer term better ways of measuring and ultimately treating pain can be developed.
Participants will take part in a single interview lasting approximately one hour. This interview will be by telephone and will be recorded. Recording will then be typed up and analysed to look for common themes. Participants will be compensated £20 for their involvement.
Participants will be recruited from the NHS Lothian Abortion service (The Choices Clinic, Chalmers Centre for Sexual and Reproductive Health).Summary of Results
Participant accounts described a mismatch between expectations and experience of pain during medical abortion.Predominately, this was due to pain being more intense or prolonged than the abortion service or other sources of information had indicated; although conversely some participants described less intense pain than expected, leading to concerns that the abortion was unsuccessful.
Descriptions of pain related to menstruation were endorsed by some participants largely noting that medical abortion was more intense than menstruation albeit the same character. Others likened the pain to early labour if they had previous births. Several participants rejected the comparison to menstruation, describing this as understating the pain of medical abortion.
Use of analgesia was variable, as was response to analgesia when it was used correctly. Non-pharmacological interventions to manage pain described by participants were largely heat-related (hot water bottles, hot wheat bags) but some participants described distraction techniques using mindfulness, video games, or television. Positioning during abortion gave pain relief for some participants.
When asked to rate pain using existing pain-rating tools, (numerical rating scales, descriptive Likert scales) the intensity of pain described in participants’ accounts was not clearly reflected in the ratings they selected from the tools. Participants with divergent pain accounts selected similar numerical ratings and verbal ratings, although an 11-point numerical rating scale appeared to better reflect the variance in experience than 6-point numerical scales or verbal ratings.
Patients require more detailed descriptions of pain during medical abortion to better prepare them for the procedure and give them clearer justification for recommended analgesia regimens.
Existing pain-rating tools inadequately capture divergent abortion-pain experiences. Development and psychometric testing of a new tool is needed.
REC name
South East Scotland REC 01
REC reference
22/SS/0088
Date of REC Opinion
31 Oct 2022
REC opinion
Further Information Favourable Opinion