This document is currently under revision.
Clinical guidance is rigorously developed to reflect the best available evidence at the time of publication. It is designed as a resource to assist clinicians in providing family planning care. It is not intended to substitute for the independent professional judgment of the treating clinician. We recognize that continued research, new understandings of person-centered care, or major changes in the legal landscape can impact clinical guidance. It should not be considered inclusive of all proper treatments or serve as the standard of care. Variations, taking into account individual circumstances, may be appropriate.

Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Clinicians ought to be aware of the safety and efficacy of different pain control regimens. This document will focus on nonpharmacologic modalities to reduce pain and pharmacologic interventions up to the level of minimal sedation. For surgical abortion without intravenous medications, a multimodal approach to pain control may combine a dedicated emotional-support person, visual or auditory distraction, administration of local anesthesia to the cervix with buffered lidocaine and a preoperative nonsteroidal anti-inflammatory drug. Oral opioids do not decrease procedural pain. Oral anxiolytics decrease anxiety but not the experience of pain. Further research is needed on alternative options to control pain short of moderate or deep sedation.