Paracervical Block for Pain Control With Osmotic Dilator Placement

Inclusion Criteria: * voluntarily seeking surgical pregnancy termination * gestational age on day of study 14w0d to 23w6d confirmed by pelvic ultrasound with a viable pregnancy (no fetal demise diagnosed) * eligible for second trimester D\&E * having osmotic dilators placed for cervical preparation the day prior to D\&E * able and willing to give informed consent and agree to terms of the study * able to speak and read English or Spanish Exclusion Criteria: * took any prescription or illegal drugs 24 hours prior to the appointment * drank alcohol 12 hours prior to the appointment * took any over the counter pain medications 12 hours prior to the appointment other than the standard 800mg of Ibuprofen * contraindications to osmotic dilators * allergic reaction or hypersensitivity to NSAIDs or lidocaine * untreated acute cervicitis or pelvic inflammatory disease * weight \<100 pounds