your guide to NHS abortions Information for women living in Lambeth, Southwark and Lewisham Produced July Review date March 2013.

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1 your guide to NHS abortions Produced July Review date March Information for women living in Lambeth, Southwark and Lewisham

2 Contents Contacts 2 Think you might be pregnant? 3 What to do if you want an abortion 5 How to book? 6 What to expect 9 Documents you will need to provide 11 Types of abortion available 12 After your abortion 15

3 Contacts Think you might be pregnant? Brook Brixton Brook Southwark Firstly, you need a pregnancy test to confirm that you are pregnant. Brook helpline (under 25 s only) Lambeth Sexual Health Service Artesian Sexual Health Service Walworth Road clinic Camberwell Sexual Health Clinic Contraception & Sexual Health Clinics Lewisham Sexual Health Direct fpa helpline (formerly Family Planning Association) The Sexual Health Information Line Free, confidential sex, relationships and contraception advice line for (7am-midnight) young people (under 18 s) NHS Abortion Central Booking Service Free pregnancy tests are available at Sexual Health Clinics and from most GPs (doctors) across Lambeth, Southwark and Lewisham. Free pregnancy tests are also available at Brook Clinics for under 25s. Brook Brixton Brook Southwark or for Lewisham or visit OR you can buy a pregnancy test kit at your local pharmacy or supermarket. They cost a few pounds and are accurate. To find details of your nearest Sexual Health Clinic, log onto or call If you are under 18 you can call This is a free, confidential sex, relationships and contraception advice line for young people.

4 Talk to someone What to do if you want an abortion If you are pregnant, you can talk to a healthcare professional about how you feel and discuss the options available to you. The staff will respect your decision, whatever you choose to do about your pregnancy. Speak to someone at your local sexual health service or call one of the numbers below: For an NHS abortion, you will need to call the Central Booking Service on They will book your appointment with the Abortion Services. Who can book a Central Booking Service appointment? Women who are registered with a GP in Lambeth, Southwark or Lewisham. Women who are not registered with a GP anywhere, but live in Lambeth, Southwark and Lewisham You will have to provide proof of address at your first appointment. fpa helpline Brook helpline (under 25 s only) Women who are registered with a GP outside Lambeth, Southwark and Lewisham should contact their own GP first. They will advise you on what abortion service is available in your borough. To find your nearest service, call the Sexual Health Information line on

5 How to book? Central Booking Service Opening hours Monday to Friday Saturday Sunday If you are having difficulty getting through or if you call when the office is closed, you can leave a message. If you call when the office is closed, someone will call you back as soon as possible or the next working day. They will not leave a message to say they have called. 8.00am to 9.00pm 8.30am to 6.00pm 9.30am to 2.30pm It is better to book your own appointment so you can answer any questions about your health and stage of pregnancy. Ask the staff at your GP surgery, Sexual Health Clinic/Service or the Brook service to help you if you are having difficulty making an appointment, are concerned about confidentiality or costs related to phone calls. Please have the following information ready when you phone to book an appointment There is space for you to write this information on the form at the back of this leaflet before you phone. You can tear the form off and take it with you to your appointment. If you find it hard to fill in the form, ask someone to help you. Date your last period started Date and results of any scans done during this pregnancy Your full name and date of birth Your full home address including postcode Contact telephone number Details of any current or past medical conditions Details of any current medication Your height and weight Full name and address, including postcode, of your GP (doctor) Name and details of the person/service that referred you for your abortion.

6 When you should book an appointment through the Central Booking Service. What to expect It is your choice whether you wish to have an abortion or continue with your pregnancy. If you are thinking of having an abortion, book an appointment as soon as possible after missing your period and getting a positive pregnancy test result. DON T DELAY! The earlier in your pregnancy you have your abortion, the safer it is. It is best to have an abortion before 10 weeks of pregnancy. Your pregnancy is counted from the first day of your last period. Most abortions are done before week 13. There are several types of abortion. The type you have depends on how many weeks pregnant you are. In England, Scotland and Wales, the law allows women to have abortions up to the 24th week of pregnancy. The following information may vary slightly depending on your personal circumstances. It will give you an idea of what you can expect on the day of your consultation. Please do not bring children with you. You can bring an adult companion to support you. You will see a nurse or counsellor who will talk to you about your pregnancy. You may be able to have a telephone conversation but make sure you are somewhere where you can talk privately. Ask them as many questions as you like. Their answers will help you decide what you want to do. You can use the conversation as an opportunity to examine all of your feelings and the possible options and outcomes. Your first appointment can last up to 3 hours. You will have a number of routine tests recommended to you in preparation for your abortion. These could include tests for Chlamydia, Gonorrhoea and HIV. A trained health professional will conduct the tests. They can explain why the tests are recommended and when and how you can expect the results. During the appointment, a nurse or healthcare advisor will explain the full range of contraception types and options available to you.

7 cont... cont... This will include Long Acting Reversible Contraception or LARC. Contraception is free and available to all women attending abortion services. You can have LARC fitted or prescribed as part of your appointment. The nurse/health advisor will ask you to think about the contraception you will use after your abortion. A followup conversation and a visit to a Sexual Health Clinic or GP is highly recommended. This will ensure that you are supported to choose and get the best from your contraception method. The staff at the Abortion Providers can direct you to local Sexual Health services. If you decide to go ahead with an abortion, you will get a second appointment to have the abortion. This usually happens within a week and sometimes sooner. Remember you can change your mind at any point. If you change your mind, please call the Central Booking Service to cancel the appointment for your abortion. If you decide to continue with your pregnancy, book an appointment for antenatal care as soon as possible. This is to make sure that you are in good health and that your pregnancy is going well. Documents you need to provide at your first appointment If you are not registered with a GP but live in Lambeth, Southwark or Lewisham, you will need to provide documents to prove your address. These could be: Driving Licence Household bills that include your name and address. For example, council tax, gas or electric bills Social Care documents If you are registered with a GP in Lambeth, Southwark or Lewisham, you will need to provide the name and address, including full post code, of your GP. OR If you are 18 or under you do not need to provide proof of your address but you do need to provide proof of your age. This can be: A Student Card Travel Card or Bus Pass Passport

8 Types of abortion available cont... The type of abortion procedure you have will depend on how many weeks pregnant you are, whether you would prefer to be awake or asleep and if you have any medical conditions. You can talk about your treatment preferences during your consultation. The abortion procedure may vary slightly at some providers. If you have to go to hospital for your abortion the procedure may be different. Medical abortion Early Medical Abortion (the abortion pill). For women up to 9 weeks pregnant at the time of the 2nd visit. Up to 3 visits in total. No surgery or anaesthetic medication used to cause an early miscarriage. Medical abortion (the abortion pill after 9 weeks). For women between 9 weeks and less than 23 weeks and 5 days of pregnancy. This involves taking medication to cause the womb to contract and push out the pregnancy. At least 2 visits are required and sometimes an overnight stay is necessary. Surgical abortion Surgical abortion up to 12 weeks of pregnancy. This is performed by gentle suction and can be carried out under local anaesthetic (awake), sedated, or under general anaesthetic (asleep). Only one visit to the treatment centre is necessary. Surgical abortion operations between 13 and 19 weeks of pregnancy. This is always carried out under general anaesthetic (asleep) or under sedation. Treatment with gentle suction is possible up to about 15 weeks. After 15 weeks, it is necessary to prepare the cervix for the products of the pregnancy to be removed with forceps and gentle suction. Only one visit to the treatment centre is necessary. Surgical abortion from 19 weeks and less than 23 weeks and 6 days of pregnancy. These procedures always require a general anaesthetic (asleep) for the final part of the treatment. It is necessary to prepare the cervix for the products of the pregnancy to be removed with forceps, followed by gentle suction. You should expect to arrive at the treatment centre early in the morning, and to stay at the centre for the whole day.

9 Types of abortion available cont... After Your Abortion There is some risk associated with all medical treatments. The possible risks and complications associated with your chosen treatment option will be explained in detail during your medical assessment prior to treatment. If you are under 14 weeks pregnant, it may be possible to have your consultation and abortion treatment on the same day. Ask the Central Booking Service for more information about this when you call. Please visit the following websites for more detailed information on the types of abortion available: > select our services > select a-z of services, > click on t. > select termination of pregnancy. > enter abortion as a term in the search field at the top of the website Follow Up Post Abortion A confidential follow-up appointment will be provided for all under 19 year olds living in Lambeth, Southwark and Lewisham. This service is likely to be expanded to include the under 25s during 2011/12. You will discuss contraception at your follow-up appointment if you have not made a decision about what to use. Contraception It is possible to get pregnant very quickly after an abortion even before you have a period. It is a good idea to sort out your contraception (family planning) before your abortion. There are long-acting reversible methods (LARC) such as the Depot Injection, the IUD ( the coil ) and the implant that can be provided at the same time as your abortion. If you decide on the pill it can be provided. You can start taking it on the day of your abortion. Visit your local Contraception & Sexual Health Clinic or GP (doctor) to discuss this or visit the following websites to find out more information:

10 Check ups Health professionals recommend that you have a check-up 2 weeks after your abortion. You can go to your GP practice or to a Sexual Health Clinic. If you need to speak to someone at any point after your abortion, you can call: The Sexual Health Information Line on or you can ask to speak to someone at your GP practice or local Contraception & Sexual Health Clinic.

11 Patient Information Form If you would like to discuss or book an abortion, please complete this form. You can use it during your call to the Central Booking Service and do bring it with you to the appointment you have arranged through the Central Booking Service. If you need help filling in this form, please ask a member of staff at your GP surgery or Contraception & Sexual Health Clinic. Have you had a chlamydia test recently? Yes / No If yes, when was it and what was the result? What do you plan to use for contraception in the future? When was your last period (when did it start)? How long is your usual cycle? (This is the time from the first day of one period to first day of the next) Do you have any illnesses or problems with your health? Are you taking any medicines? It is best if you can get information to help you decide this at your local Contraception & Sexual Health Clinic before your appointment. You can also get information at your appointment. Start contraception immediately after your abortion. if you do not wish to become pregnant again. To make your appointment call the Central Booking Service My appointment: Date: Time: Place: Notes What is your weight? What is your Height?

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