February 2025: Acute Pain Management in Non-Labor and Delivery OBGYN Procedures

Even non-labor and delivery (non-L&D) OBGYN procedures require patients’ bodies to be positioned in, arguably, one of the most vulnerable possible ways. Patients are physically, epistemically, and emotionally at the mercy of their clinicians, so clinicians’ characters and pain management strategies during such procedures could not be more worthy of ethical investigation. Communication and analgesia approaches are clinician-dependent and, thus, heavily reliant upon clinicians’ capacities to discern patients’ needs and to charitably—and as accurately as possible—interpret patients’ pain responses, and to generously construe what patients deserve. Expressions of gender identity, racial, ethnic, and age biases in OBGYN settings have a treacherous, violent history with long legacies and persistent influence on many patients’ experiences. This theme issue considers acute non-labor and delivery (non L&D) OBGYN pain specifically; when pain of patients undergoing these procedures is addressed inadequately or callously, patients are at risk.

We invite manuscripts considering wide ranging topics, including drivers of patients’ pain and pain management expectations; social media trends in how pain during intrauterine device placement or other procedures is discussed; how general tolerance of some clinicians’ inadequate management of non L&D OBGYN pain should be contextualized among broader obstetric and gynecological violence trends; how we should understand some clinicians’ poor communication about non L&D OBGYN procedures and pain; how we should navigate uncertainty about analgesia guidelines and interpret extant standards of care; and how we should consider ethical responsibility of clinicians to assess their practices and orientations to iatrogenically harmful features endemic to non L&D OBGYN care.

Manuscript submission deadline has passed.

The AMA Journal of Ethics® invites original, English-language contributions for peer review consideration on the upcoming themes.