Contraceptive Pearl: Non-pharmacologic Pain Management

IUD or implant insertion may cause pain, anxiety, and fear. Clinicians can use interpersonal techniques to reduce patients’ perception of pain.

Mary Stopes International calls this method the Vocal Local technique. Also known as distraction therapy or “verbicain,” the Vocal Local method serves to support women through procedures. This technique allows clinicians to manage patients’ anxiety verbally, leading to an easier procedure for both the patient and the provider.

You can introduce the method to patients by saying, “I am going to talk with you during the procedure because I know if you are talking, you are breathing; and if you are breathing, your body tends to be more relaxed.”

Take these simple steps to reduce patients’ pain and anxiety:

Describe what the patient will experience.

  • Women who know what to expect feel less fear.

Recognize her pain.

  • Earn the patient’s trust by showing that you believe her pain. Acknowledge what she is feeling physically and emotionally. Do not discount anxiety, fear, or cramps.

Distract the patient.

  • Focus the patients’ attention elsewhere by engaging her in conversation. Asking her open-ended questions may help. Safe topics include her interests, her plans for the day, career, and family.
  • Comment on what you know about her: jewelry, tattoos, piercings, where she’s from.
  • Play music. Several studies indicate that patients perceive less pain when listening to music.

Encourage muscle relaxation.

  • Tight muscles lead to increased pain. Encourage the patient to breathe deeply and deliberately relax her muscles.

These simple techniques are easy to incorporate into IUD and implant insertion procedures, and they lead to a better experience for clinicians and patients.



Vocal Local Training Materials, developed by the Miscarriage Management Training Initiative, a program of  Provide

Patient Education Fact Sheets

Adolescent Procedure Preparation Guide



Czarnecki ML, Turner HN, Collins PM, Doellman D, Wrona S, Reynolds J. Procedural pain management: a position statement with clinical practice recommendations. Pain Manag Nurs. 2011 Jun;12(2):95-111. Epub 2011 Apr 29. PMID: 21620311.

Renner RM, Jensen JT, Nichols MD, Edelman A. Pain control in first trimester surgical abortion. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD006712. DOI: 10.1002/14651858.DC006712.pub2.



The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.