UNDERGOING TERMINATION OF PREGNANCY AFTER 12 WEEKS



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UNDERGOING TERMINATION OF PREGNANCY AFTER 12 WEEKS Information Leaflet Your Health. Our Priority.

Page 2 of 5 The staff at Stepping Hill Hospital will support you as much as we can during this sad time. Please make sure you fully understand what is happening. Please read this leaflet carefully before receiving your treatment and ask the doctor or midwife to explain any points you are not clear about. The Treatment The treatment will consist of taking one mifepristone tablet by mouth, (this contains a drug which acts by blocking the effects of the hormone progesterone, and improves the effectiveness of the next part of the treatment). After approximately 36-48 hours you will be admitted to hospital and start a course of Misoprostol vaginal pessaries (more effective and fewer side effects) or oral tablets, one every 3 or 6 hours (depending on how many weeks pregnant you are). Usually up to 5 doses can be given although the length of course of treatment may vary depending on your history. These contain a different type of chemical (called prostaglandin) which causes contractions to start. If you are approaching or beyond 22 weeks pregnant the doctor and midwife will discuss additional treatment you may need. You will be referred to St Mary s Hospital, Manchester for this. Is the treatment suitable for you? Most women can have the treatment. The treatment may be unsuitable if: You have a heart complaint or are receiving treatment for high blood pressure. You suffer badly from asthma, bronchitis or have diabetes. You suffer from any other serious conditions or are taking medicines of any kind. You have high blood cholesterol levels. You have reacted to or are allergic to mifepristone. You are a smoker aged over 36 years. You are breastfeeding (breastfeeding should stop for at least 14 days, your doctor will advise when you can restart breastfeeding). What about other medicines? Some other medicines may interfere with the treatment and should not be used until it is over. These include pain relieving tablets such as aspirin, ibuprofen and mefenamic acid. If you are taking any other medicines, please tell the doctor. Possible side effects of the Mifepristone You may have no side effects at all after taking the tablets. Sometimes you can feel faint or sick. If you are sick please phone Delivery Suite and let us know. Sometimes you can have a headache, skin rash, and may have some bleeding or stomach cramps. If any of these occur, please phone Delivery Suite for advice.

Page 3 of 5 PLEASE DO NOT DRINK ALCOHOL OR SMOKE ONCE YOU HAVE TAKEN THE MIFEPRISTONE TABLETS AND UNTIL YOU HAVE DELIVERED AND BEEN DISCHARGED FROM STEPPING HILL HOSPITAL (These are recommendations from the drug manufacturers). How will I have the treatment? Once you feel you have had time to reach an informed decision, the doctor will ask you to sign a consent form. A time will be arranged for you to come to Delivery Suite (1 st floor, Women s Unit), or to be seen in Antenatal Clinic. You will be given a tablet (called mifepristone) to swallow with some water. You will then be asked to remain on Delivery Suite or in Antenatal Clinic for approximately 20 minutes. You can then go home, but please contact Delivery Suite if you want to discuss anything or are concerned. Tel No. 0161 419 5553. You will be given a time to return to Delivery Suite 36 hours later (usually about 9am) to continue the treatment. What to expect? It is difficult to say how long your treatment will take. It would be unusual for the process to start after taking the Mifepristone. After the Misoprostol is given in hospital, things may happen quickly or you could be in for several days. The midwives and doctors will guide you and offer you as much care and support as you need. You will probably feel contractions and will be offered pain relief if needed. You can discuss the options for pain relief with the midwife or Anaesthetist on Delivery Suite. We will try to care for you in Sandalwood, a private suite of rooms on Delivery Suite but cannot guarantee this. Please bring in anything to help you feel more comfortable. Useful things to bring in with you: Toiletries/towels Own pillow Sanitary towels, comfortable pants Additional snacks and food Books / magazines As you deliver your baby we will support you and help you through this difficult time. At some point, when you are ready to discuss it, we will offer you choices for investigations, seeing your baby, creating mementos and options for a funeral. Please don t feel rushed into any decisions. If you have any questions at any time during your stay PLEASE discuss them with the midwife or doctor. Once you have gone home, we will continue to offer you as much support as you feel you need. Your Team Midwife can visit you at home, and we will inform your General Practitioner. We will give you a list of contact numbers for further information and support, and the Bereavement Specialist Midwife will contact you as soon as she is able to.

Page 4 of 5 Supervisors of Midwives Need extra information, support or advice? Contact a Supervisor of Midwives by ringing the main switchboard at Stepping Hill Hospital: 0161 483 1010. A Supervisor of Midwives is available 24 hours a day. Supervisors are concerned with ensuring the safety and well-being of mother and baby and with the provision of high quality midwifery care. Important Numbers Delivery Suite 0161 419 5553 Antenatal Clinic 0161 419 5291 Bereavement Specialist Midwife 0161 419 5526 Bereavement Office 0161 419 5034 Hospital Chaplains 0161 419 5889 Antenatal Results and Choices National Helpline 0845 077 2290 (a charity providing information and support)

Page 5 of 5 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: 0161 419 5678. Email: PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number MAT01 Publication date July 2016 Review date July 2018 Department Women s Unit Location Stepping Hill Hospital