Since we use very narrow cannulas, there is no need to dilate the cervix. Since the insertion of a large cannula or other instruments is the main cause of pain in an abortion, the need for any anesthetic is eliminated.
Most women are able to tolerate insertion of the 4 mm. cannula into the cervix to extract the menstrual period. If a woman has heavy cramping and her uterus is tender, she may find it more painful; on the other hand, she may decide to endure some minor pain to see if extracting the menstrual material, especially clots, gives her relief from the cramping.
A lot depends on the circumstances. If a woman’s period is late and she suspects that she is pregnant, then she decides to do menstrual extraction even if there is some discomfort in inserting the cannula. We have done menstrual extractions in situations where abortion was illegal. Once, in those circumstances, the woman’s cervix was quite sensitive, but she was willing to endure pain in order to proceed.