{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T23:54:09Z","timestamp":1788566049430,"version":"build-2803163510"},"reference-count":30,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100008509","name":"Open University","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100008509","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["207878\/Z\/17\/Z"],"award-info":[{"award-number":["207878\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2024,2,13]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore experiences of pain in the context of early medical abortion (EMA) in the UK and to guide best practice around anticipatory guidance on pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From late 2020 to early 2021, we recruited individuals from across the UK who had undergone abortion during the COVID-19 pandemic to participate in in-depth, semi-structured telephone interviews. A storytelling approach was used and data were analysed thematically using NVivo 12 software.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Focused coding and thematic analysis addressed accounts of pain, which were prominent in many interviews. We constructed the following subthemes: expected pain is manageable for some; the problem with unexpected pain; pain (co)produces fear; and problematising \u2018period-like pain\u2019. The key issue which our analysis draws out is that while EMA pain experience might vary, for some it may be much worse than anticipated. Moreover, the common trope of likening it to \u2018period pain\u2019 can be misleading and a source of additional uncertainty at a potentially already challenging time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>For some individuals, pain experienced in EMA will be severe and\/or worse than expected. Insufficient preparation for pain can result in extremely negative experiences of EMA. Alongside development of improved analgesia, improvements should be made to anticipatory guidance on pain, particularly for those self-manging EMA at home. Framings of \u2018period-like pain\u2019 do not clarify expectations and should be avoided.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2023-202198","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T13:20:31Z","timestamp":1709299231000},"page":"3-8","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Foregrounding pain in self-managed early medication abortion: a qualitative study"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-9201","authenticated-orcid":false,"given":"Carrie","family":"Purcell","sequence":"first","affiliation":[{"name":"Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-6286","authenticated-orcid":false,"given":"Victoria Louise","family":"Newton","sequence":"additional","affiliation":[{"name":"Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3347-6403","authenticated-orcid":false,"given":"Fiona","family":"Bloomer","sequence":"additional","affiliation":[{"name":"School of Applied Social and Policy Sciences, Ulster University, Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4786-7950","authenticated-orcid":false,"given":"Lesley","family":"Hoggart","sequence":"additional","affiliation":[{"name":"Faculty of Wellbeing, Education and Language Studies, The Open University, Milton Keynes, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"key":"2025090511533246000_51.1.3.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2023-201949"},{"key":"2025090511533246000_51.1.3.2","first-page":"100200","article-title":"Safety and effectiveness of self-managed medication abortion provided using online telemedicine in the United States: a population based study","volume":"10","author":"Aiken","year":"2022","journal-title":"Lancet Reg Health Am"},{"key":"2025090511533246000_51.1.3.3","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15684"},{"key":"2025090511533246000_51.1.3.4","unstructured":"Guttmacher Institute . Medication abortion 2023. Available: https:\/\/www.guttmacher.org\/state-policy\/explore\/medication-abortion [Accessed 4 Dec 2023]."},{"key":"2025090511533246000_51.1.3.5","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1080\/01443615.2019.1634027","article-title":"Management of pain associated with up-to-9-weeks medical termination of pregnancy (MTOP) using mifepristone\u2013misoprostol regimens: expert consensus based on a systematic literature review","volume":"40","author":"Fiala","year":"2020","journal-title":"J Obstet Gynaecol"},{"key":"2025090511533246000_51.1.3.6","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2014.950730"},{"key":"2025090511533246000_51.1.3.7","doi-asserted-by":"crossref","unstructured":"Arena A , Moro E , Degli Esposti E , et al . How much will it hurt? Factors associated with pain experience in women undergoing medication abortion during the first trimester. Contraception 2023;119. doi:10.1016\/j.contraception.2022.11.007","DOI":"10.1016\/j.contraception.2022.11.007"},{"key":"2025090511533246000_51.1.3.8","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/aogs.13920","article-title":"Pain during medical abortion in early pregnancy in teenage and adult women","volume":"99","author":"Kemppainen","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025090511533246000_51.1.3.9","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/j.ejogrb.2015.09.025","article-title":"Pain during medical abortion: a multicenter study in France","volume":"194","author":"Saurel-Cubizolles","year":"2015","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025090511533246000_51.1.3.10","first-page":"11","article-title":"Pain perceived during drug-induced abortion in general practice: evaluation and predictive factors","volume":"179","author":"Puel","year":"2022","journal-title":"Exercer-La Revue Francophone De Medecine Generale"},{"key":"2025090511533246000_51.1.3.11","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1080\/13625187.2017.1315092","article-title":"Assessment of pain during medical abortion with home use of misoprostol","volume":"22","author":"Cavet","year":"2017","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090511533246000_51.1.3.12","unstructured":"Royal College of Obstetricians and Gynaecologists . Best practice in abortion care. 2022. Available: https:\/\/www.rcog.org.uk\/media\/geify5bx\/abortion-care-best-practice-paper-april-2022.pdf [Accessed 4 Dec 2023]."},{"key":"2025090511533246000_51.1.3.13","unstructured":"World Health Organization . Abortion care guideline. 2022. Available: https:\/\/iris.who.int\/bitstream\/handle\/10665\/349316\/9789240039483-eng.pdf [Accessed 4 Dec 2023]."},{"key":"2025090511533246000_51.1.3.14","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.contraception.2022.08.005","article-title":"Pain management for medical abortion before 14 weeks' gestation: a systematic review","volume":"116","author":"Reynolds-Wright","year":"2022","journal-title":"Contraception"},{"key":"2025090511533246000_51.1.3.15","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.contraception.2022.03.003","article-title":"The experience of pain in real-time during medication abortion","volume":"110","author":"Friedlander","year":"2022","journal-title":"Contraception"},{"key":"2025090511533246000_51.1.3.16","doi-asserted-by":"crossref","unstructured":"Wong ML , Achu RA , Spence NZ , et al . Feasibility of methadone for pain relief in first trimester abortion. 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NVivo 12 qualitative analysis software. 2017. Available: www.lumivero.com"},{"key":"2025090511533246000_51.1.3.28","unstructured":"Spencer L , Ritchie J , O\u2019Connor W , et al . Analysis in practice. In: Ritchie J , Lewis J , Ormston R , et al , eds. Qualitative Research Practice. London: Sage, n.d.: 295\u2013346."},{"key":"2025090511533246000_51.1.3.29","doi-asserted-by":"crossref","first-page":"889","DOI":"10.2147\/JMDH.S399209","article-title":"\u201cOut of this world\u201d: Norwegian women\u2019s experiences of medical abortion pain","volume":"16","author":"R\u00f8seth","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"2025090511533246000_51.1.3.30","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-019-0816-0","article-title":"Experiences with pain of early medical abortion: qualitative results from Nepal, South Africa, and Vietnam","volume":"19","author":"Grossman","year":"2019","journal-title":"BMC Womens Health"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2023-202198","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:05:44Z","timestamp":1757099144000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2023-202198"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,6]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bmjsrh-2023-202198"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2023-202198","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,1]]}}}