Although it’s natural to feel scared or anxious about experiencing pain during any abortion procedure, most women find the cramping tolerable.
If you are having a medication abortion at home, you’ll want to be somewhere where you can lie down and be close to a toilet. Use pillows for support, and try to find a comfortable position. A heating pad or hot water bottle may help relieve the cramps, and deep rhythmic breathing, which you can do on your own or with a support person, may help reduce pain and anxiety.
Your provider may offer a prescription for pain medication or suggest over-the-counter pain relievers. Ibuprofen is the generally the most effective painkiller for cramps. You can also use other nonsteroidal anti-inflammatory drugs such as naproxen (Aleve) and diclofenac. Acetaminophen (Tylenol) or aspirin also help, though aspirin may increase the bleeding.
Do not use mefenamic acid (Dolfenal) or other antispasmodics; misoprostol makes your uterus contract in order to push out the pregnancy, and mefenamic acid or antispasmodics can interfere with the abortion process.
For vacuum aspiration abortion, local anesthesia injected into the cervix helps relieve pain that may occur during dilation (opening) of the cervix. In addition, the clinic may offer medications either orally or through an IV that will help you relax and feel less discomfort and anxiety. Sometimes called moderate intravenous sedation or conscious sedation, these medications are different from general anesthesia and will not cause you to lose consciousness.
Some facilities offer general anesthesia for women who want to be asleep during the abortion. However, because general anesthesia can, in rare cases, cause complications — such as breathing problems, failure of the uterine muscles to contract normally (uterine atony), and bleeding — it is usually not used for abortion.
Each of us experiences and copes with pain differently; talk with your provider about what the clinic offers, the difference in cost, and what will work best for you.