5. MEDICATIONS, PAIN MANAGEMENT, AND MANAGING EMERGENCIES

^{Updated 2025 by Divya Bhatia MD; Meera MD; and Nikia Grayson DNP, MPH, CNM, FNP-C}

This chapter describes methods of pain management as well as medications used before, during, and after uterine aspiration including medications indicated for clinical emergencies. For pain management options for medication abortion, see Ch 4.

Chapter Learning Objectives

Following completion of this chapter, you should be able to:

• Describe the role of antibiotic prophylaxis and cervical preparation in uterine aspiration
• List when to test for Rh type and use Rh-D immunoglobulin (IG) to prevent isoimmunization
• List pain management options for uterine aspiration, effectiveness, and considerations for people who use opioids
• Describe precautions and technique for paracervical block
• Offer all options for person-centered care for individualized pain management
• Identify appropriate responses to and medications for clinical emergencies

Videos

• Pain with Uterine Aspiration Abortion (IERH)
• Paracervical Block Animation (Hologic)

Readings / Resources

• Clinical Recommendations for Pain Control (SFP)
• Paracervical Block Technique (Ipas)
• English Spanish Word Choice Exercise (TEACH)
• Managing Pain for Patients using Medication-Assisted Treatment for OUD (NAF)
• Medical Emergency Simulations (TEACH)