'Outpatient reception staff
helping people at the TR clinic'
You will be given detailed instructions about what to do and bring
with you before your termination clinic appointments. Please remember
that all of the staff at the termination clinic want to help you.
Please tell us if you are worried or unsure of anything at any time
during your appointment.
How long will my first visit take?
For your first visit to the termination clinic, you should allow
up to three hours.
Is there somewhere I can leave my children while I am being
seen in Clinic?
If you have to bring your children to the clinic with you, you
can use the Rosie Outpatient
Clinic play area. Please note, they are not allowed to go
into the outside play area unless a play leader is on duty.
What should I bring with me?
Bring any letters, forms (including certificate A if you have
one). And come with a full bladder to help with the ultrasound
scan (ie drink a lot and don't 'pee' just beforehand).
Where do I need to go?
For your first visit, go to the Rosie Hospital (on Robinson Way),
and find the Outpatient Clinic on the ground floor, which is to
the right of reception.
Where do I need to check in?
The Outpatient Clinic receptionist will check your details -
name and address etc. - to make sure that we have up-to-date information
for you. She will also ask for any forms or letters that your
GP or clinic gave you to bring to the appointment. She will explain
where to find the scan department in the Rosie (just across the
corridor).
Why do I need an ultrasound scan?
We will offer you an ultrasound scan to accurately date your
pregnancy. The scan is best done when you have a full bladder
because ultrasound waves give better pictures when they have passed
through water (or urine) and your bladder is in front of your
uterus at this early stage of pregnancy. For your comfort, we
get this test done first - then you can have a pee whenever you
want one.
What can you tell from the scan?
The ultrasound scan can accurately date your pregnancy but it
can also tell us if you are already experiencing a natural miscarriage
or (more rarely) that you have an ectopic (tubal) pregnancy that
needs urgent treatment. We can also see ovarian cysts and twin
pregnancies.
What happens if I need treatment because of what you find on
my scan?
If we find you are already undergoing a natural miscarriage or
that you have an ectopic pregnancy, you will be referred directly
to the Early Pregnancy Unit (EPU) at the Rosie
Hospital. They can give you information and advice about what
further investigation or treatment you may need.
What does the scan involve?
You will be offered a trans-abdominal ultrasound scan, which
means one using sound waves from a probe placed on your abdomen
(tummy). This doesn't hurt. The ultrasound scan is carried out
in a private room in the scan department. You will be asked to
lie on a bed and to uncover your abdomen. The radiographer will
put some jelly on the skin of your lower abdomen and then move
an instrument over the skin until she picks up a picture of the
uterus (womb). The radiographer will look at the screen and will
work out your pregnancy dates. The screen will normally be turned
away from you, unless you ask to see the picture.
What if the radiographer can't get a good picture?
It helps the scanner if you have a full bladder. After you have
drunk lots of water, your bladder becomes full but it can be difficult
to drink enough (and hold onto it) to give a good picture with
the scan method above. Sometimes, even though the bladder is full,
it can be impossible to get an accurate picture of what is happening
in the uterus. This might be due to a lot of gas in your bowel
(wind) or because the pregnancy is very early (and is therefore
very small). In this situation, the radiographer might offer you
a vaginal scan. For this scan, you will need to remove your pants,
and the radiographer will place a small probe (covered with a
mini 'condom') gently into your vagina. Because this probe is
much closer to the pregnancy, it gives more accurate images but
we offer it as a second choice because most people would prefer
to just have a probe on their abdomen.
What happens after the scan?
After you have had your scan, the radiographer will write a short
report and you will be given this to bring back to the termination
clinic. You will probably want to visit the toilet on the way.
When you return to the clinic with your scan report, you should
give this to the receptionist. She will ask you to take a seat
until the doctor or nurse is ready to see you.
Will I need to wait for long?
We know this can be a stressful time for you and we do our very
best to see you as quickly as possible. Sometimes, there is a
bit of a wait at this stage because some patients need more time
to have their scan.
Who will I meet in the Clinic?
When it is your turn, you will be called to the clinic by a doctor
or nurse, who will introduce themselves to you. Most of our staff
also work at the family planning clinic or in other women's clinics
at Addenbrooke's and most are female. Some patients are seen first
by the doctor and some are seen first by the nurse. Most need
to see both before their consultation is completed.
What will you discuss with me at the Clinic?
You can be sure that none of the clinic staff will criticise
you for being pregnant. We know that contraception isn't perfect
and that we all make mistakes at times. We also know that for
some people circumstances change after they get pregnant, which
makes them feel it is impossible to continue the pregnancy. We
will need to ask you some questions for your own safety and to
help us recommend a method of termination to you - if that is
still what you want.
-
Contact details: During the consultation, we will
ask you about how we can contact you and will make a note
of with whom you are willing to allow us to leave a message.
-
Your general practitioner: If you were not referred
to the clinic by your general practitioner (GP), we will ask
if you agree to us writing to them to tell them about your
consultation. It is generally best if your GP knows about
you having an termination, in case you have any complications.
If you prefer them not to be informed, then we will respect
your wishes and you can return to the family planning clinic
for any follow ups.
-
Your medical history and previous pregnancies: Whoever
(nurse or doctor) you see first will take details of your
medical history from you, and will also ask about this and
previous pregnancies. The doctor will briefly discuss your
scan results with you.
-
Your contraceptive history: You will be asked about
what methods of contraception you have used in the past, and
what you were using, if anything, at the time you got pregnant.
This is all so that we can help you to find a method
of contraception that will suit your needs better in the
future.
-
About your decision: By the time most women come
to the termination clinic they are already sure of their decision
to have a termination. However, many are not at all sure,
and it is important that you make this clear to us. We will
listen sympathetically to the reasons for your uncertainty
and discuss with you your options for finding further help.
Even if you are not yet 100% sure, we are happy to go ahead
and make the necessary arrangements for a termination. This
means that, if you decide to have a termination, you have
a definite date booked. If you decide to continue with the
pregnancy, you can cancel these arrangements at any time.
This is preferable to delaying booking the termination while
you decide.
-
Methods of termination:
We will explain the different methods of termination that
are available to you. We can help you decide which method
you prefer. We find that it is helpful to find out about the
available methods before the clinic appointment - it is often
easier to decide before the visit.
-
Appointment date: When you have decided which method
of termination you would prefer, you will be given a date
for the procedure. If you have seen a nurse first, this arrangement
has to be confirmed when you see the doctor. This is because
it is a legal requirement in the
UK for two doctors to decide that your circumstances are
covered by the Abortion Act.
-
Forms and paperwork: The clinic staff will complete
most of your paperwork for you, but you will be required to
sign a consent form for the termination. If you have opted
for a surgical termination at the Day
Surgery Unit, you will also have to sign the 'fitness
for day care' questionnaire.
-
Healthchecks: For your safety, we will carry out
a general medical examination, take a blood sample (from your
arm) and some swabs to test for infections. The nurse will
check your blood pressure, weigh you and measure your height.
-
Examination: After you have talked to the doctor,
you will go into an examination room, where you will be asked
to undress below your waist and to lie on a couch. After listening
to your chest, the doctor will carry out a vaginal examination
to feel your womb, which involves putting one or two fingers
into your vagina, with the doctor's other hand on your lower
tummy. To take the swabs, the doctor will gently place a speculum
into your vagina (it can feel a bit cold) and then gradually
open it so that some swabs can be taken from your cervix.
If you need one and have requested it, the doctor can also
take a smear test at this time. The doctor will then remove
the speculum and take a further swab from your urethra (the
external opening from your bladder).
Can I receive detailed counselling at the Clinic?
The termination clinic is quite busy and we do not have time
during the clinic for the lengthy counselling that you might need.
We can suggest and make arrangements for other people and organisations
to contact for counselling
Why do you take swabs at the first appointment?
It is common to have mild infections in your vagina, which might
not normally give you any symptoms or problems. Terminations that
use instruments carry the risk of infections of the womb, which
usually are carried in from the vagina or cervix. At your first
visit, we take swabs to test for these infections so that we can
give you some antibiotics at the time of your termination if the
swabs are positive. The two infections that we are most interested
in detecting are bacterial
vaginosis and chlamydia.
If I have an infection, what does this mean to me and my partner(s)?
If you have bacterial vaginosis, which isn't caught during sex,
we will offer you some antibiotics at the time of the termination.
Your partner doesn't need treatment for this. If you have a chlamydia
infection, which can be caught during sex, we will offer you some
antibiotics at the time of the termination and advise you to recommend
that any partners you have had sex with also receive treatment.
Chlamydia is often symptomless.
Does the examination hurt?
For your safety, it is important that we learn about the health
of your vagina, cervix and womb. Millions of women have these
'internal examinations' each year - most agree that they are a
bit uncomfortable rather than actually hurting. If it is your
first examination, it might be more uncomfortable especially if
you are tense or anxious. Some women always find vaginal examinations
particularly difficult. We aim to be very gentle with all our
patients, but please tell us if you have particular fears about
this.
Do I have to have the swabs?
The swabs are most important if you are having a surgical termination.
It is good clinical practice to only treat known infections, which
is why we prefer to test you before treating you with antibiotics.
If you really feel that you can't have the swabs, then we can
give you antibiotic 'cover' before the operation, just in case
you have an infection. If you will be having a general anaesthetic,
it is possible for us to take the swabs while you are asleep.
Then, if we find a chlamydia infection, your sexual partner can
also be treated.
What are the blood tests for?
The blood tests provide us with information for your safety:
-
Full blood count: this shows us if you are anaemic (not
enough red blood cells).
-
Blood group: Knowing your blood group is important for two
reason: (1) If you have the rhesus negative blood group you
will be given an 'anti-D' injection at the time of your termination
to protect any future pregnancies from being affected by rhesus
incompatability. (2) If you are one of the very few people
who need to have a blood transfusion, knowing your blood group
lets us give you the right sort of blood products.
-
Other tests: Depending on your medical history, you might
need other tests, which will be discussed with you.
How are the blood tests taken?
The blood test is usually taken by a phlebotomist in the clinic.
She will ask you to sit down for it but if you have a tendency
to feel faint, you should ask to lie down for the blood test.
The blood is usually taken from a vein on the inside of your elbow.
Using modern blood-taking systems, it is usually only necessary
to put the needle into your arm once. This will be sore a little
for a second or two. First, a tourniquet (band) is put around
your upper arm and tightened to make the veins at your elbow stand
out more. Then a small needle is put into the vein. After the
needle has been removed, you will be asked to press firmly over
the area for a few minutes - this should prevent most bruising.
We keep a local anaesthetic cream in the clinic, which we can
use for anyone who is especially nervous about blood tests. However,
this takes an hour to work properly, so, if you think you will
need this you need to tell us as soon as you get to the clinic.
Also on this website
|
