Predictors and perception of pain in women undergoing first trimester surgical abortion

Rameet H. Singh, Khalil G. Ghanem, Anne E. Burke, Mark D. Nichols, Kathy Rogers, Paul D. Blumenthal

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: The aim of the study was to evaluate pain and predictors of pain in women undergoing electric (EVA) or manual vacuum aspiration (MVA) for first trimester surgical abortions and to examine how perceptions of pain differ among participants, advocates (participant support person) and physicians. Study Design: In this randomized controlled study, women presenting for first trimester abortion underwent standardized EVA or MVA. Participants completed questionnaires, visual analog scales (VAS) and Likert scales for pain. Logistic and linear regression models were used to analyze the data. Results: Nonwhite women and women who preoperatively expected more pain reported higher procedure-related pain scores. Vacuum source, previous history of abortion, comfort with decision to have an abortion and partner involvement did not affect participant pain scores. In the multivariable analyses, no single factor predicted procedure-associated pain. The advocates perceived that more educated women had less pain. Physicians felt longer procedures and a woman's fear of pelvic examinations caused more pain. Physicians believed women had less pain than the participants reported themselves (p<.001). Only physicians thought that EVA was less painful than MVA (p<.01). Conclusion: Distinct factors other than vacuum source affect the perception of abortion-related pain. Understanding these factors may help inform counseling strategies aimed at ameliorating pain perception during first trimester abortions.

Original languageEnglish (US)
Pages (from-to)155-161
Number of pages7
Issue number2
StatePublished - Aug 2008


  • Abortion
  • Aspiration
  • Electric
  • Manual
  • Pain
  • Vacuum

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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