Pain control is a significant concern for women undergoing surgical abortions with the most of women experiencing at least moderate levels of pain. Intravenous sedation has been shown to significantly reduce pain during these procedures, but the majority of abortion providers use only local anesthesia for pain control. Heat is an effective modality used for pain management in other fields of medicine. To date, there are no studies investigating it’s utility for intraoperative pain management during first trimester abortion procedures. We conducted a randomized double blind control trial to investigate the effect of applied topical on perceived pain at various time points during first trimester abortion procedures perfomed under only local anesthesia. Data were analyzed using an intention to treat and per protocol analyses. In the per protocol analysis, we found that intraoperative heat therapy did decrease pain at the time of uterine aspiration, but the reduction was not clinically significant based on a threshold set by earlierpain studies.