title: Predictors and perception of pain in women undergoing first trimester surgical abortion.
abstract: 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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. rsingh6@jhmi.edu
authors.forename: Rameet H
authors.initials: RH
authors.lastname: Singh
authors.forename: Khalil G
authors.initials: KG
authors.lastname: Ghanem
authors.forename: Anne E
authors.initials: AE
authors.lastname: Burke
authors.forename: Mark D
authors.initials: MD
authors.lastname: Nichols
authors.forename: Kathy
authors.initials: K
authors.lastname: Rogers
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blumenthal
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010146:Pain / Q000523:psychology*; D010147:Pain Measurement; D010465:Perception; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D014619:Vacuum Curettage / Q000009:adverse effects*