Journal of Midwifery & Women's Health, May 2016, Vol.61(3), pp.331-338
Byline: Mary Tschann, Jennifer Salcedo, Bliss Kaneshiro Keywords: first-trimester abortion; pain management; nonpharmaceutical; nonpharmacologic; integrative; critical review Introduction First-trimester aspiration abortion is associated with moderate to severe pain. The effectiveness of adjunctive therapies for pain control is not well understood. This critical review summarizes the existing literature regarding nonpharmacologic interventions to reduce pain during first-trimester office-based abortion. Methods PubMed and Google Scholar were searched using the following search terms in various combinations: "abortion," "pain," "nonpharmaceutical," "nonpharmacologic," "anxiety," "fear," "pain management," "pain reduction," "anxiety reduction," "complementary and alternative medicine," and "integrative medicine." Seven articles meeting inclusion criteria were entered into a matrix for comparison. Findings from each study are summarized describing design, results, and themes. These results are summarized to provide evidence-based clinical guidelines and identify areas for further research. Results None of the nonpharmacologic interventions studied were significantly associated with a reduction in pain or anxiety scores. However, women in many studies strongly endorsed future use of these techniques. Discussion The data included in this critical review did not demonstrate a relationship between the nonpharmacologic interventions and pain or anxiety scores, yet participants endorsed these as positive and helpful. Women found value in these supportive interventions, and ongoing investigation into these techniques is warranted. Biographical information: Mary Tschann, MPH, is a Junior Researcher for the Department of Obstetrics, Gynecology, and Women's Health at the University of Hawaii, John A. Burns School of Medicine. She is also a doctoral student in Clinical Research at the University of Hawaii. Jennifer Salcedo, MD, MPH, MPP, is an obstetrician-gynecologist and Assistant Professor at the Department of Obstetrics, Gynecology, and Women's Health at the University of Hawaii, John A. Burns School of Medicine. Dr. Salcedo also directs family planning and adolescent health residency education for the department. Bliss Kaneshiro, MD, MPH, is an obstetrician-gynecologist and Associate Professor with Tenure at the Department of Obstetrics, Gynecology, and Women's Health at the University of Hawaii, John A. Burns School of Medicine. Dr. Kaneshiro is also the medical director for Hawaii's Title X Program.
First‐Trimester Abortion ; Pain Management ; Nonpharmaceutical ; Nonpharmacologic ; Integrative ; Critical Review