Accuracy of providers' assessment of pain during intrauterine device insertion.

Background: Providers often underestimate patient pain. This study investigated if providers accurately assess pain during intrauterine device (IUD) insertion.

Study Design: This is a secondary analysis of a randomized trial. Participants rated pain on a 100-mm visual analogue scale (VAS). Providers marked a similar VAS for maximum level and timing of participant pain.

Results: The mean patient maximum pain was 64.8 mm (SD, 27) compared to 35.3 mm (SD, 26) rated by the provider (p<.001). Patient and provider agreement on most painful time point of procedure was weak (kappa statistic, 0.16).

Conclusions: Providers underestimate pain during IUD insertion.

Implications: To our knowledge, this is the first paper to compare provider and patient perceptions of pain during IUD insertion. Understanding this relationship will help guide further research about IUD insertion pain and techniques and could improve patient counseling.