Aftercare information



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Aftercare information It is essential that you read this information carefully and take it home with you for future reference and reassurance. If you experience anything you are concerned about and cannot find sufficient advice within this booklet, please access the aftercare section on our website or ring our helpline which is available day and night. Please note the nurse on the aftercare line will be able to access your medical history (once the security checks have been verified). All details are documented for continuity of care and therefore any member of our dedicated nurse team will be able to assist you. 1

Marie Stopes United Kingdom 24 hour Aftercare Line 0845 122 1441 (call charges apply) Overseas callers 00 44 845 122 1441 Website: www.mariestopes.org.uk Irish women can also get help and advice from Reproductive Choices in Dublin (01) 830 0630 2

Bleeding Everyone is different and the following are quite normal events: You may not bleed straight away it can take up to 5 days after treatment and when you do bleed it may be heavy with some clots and can last from 2-10 days, with some cramping sensations. You may have no bleeding at all. You may experience light bleeding coming and going and continuing for up to six weeks or longer but this should settle after you have your first period. 3

When to be concerned If you are soaking through more than 2 high absorbency pads an hour for more than 3 hours we advise you call the aftercare helpline and discuss this with the nurse who will carry out a further assessment and advise on the next course of action. 4 Managing your pain Pain is different for everyone: Once you start to experience pain, this may come and go for up to 2 weeks It can typically be felt in the lower abdomen, lower back and the tops of the legs

Do take regular pain killers but avoid ones that contain Aspirin Heat pads/hot water bottles can be used and may give comfort for any cramp type pain We strongly advise you to take non-steroidal anti-inflammatory pain killers i.e. ibuprofen regularly for the first 24-48 hours in line with the manufacturer s instructions (if you are unable to take ibuprofen due to asthma, SSRI anti-depressant therapy, history of peptic ulcers/bleeding or renal failure, we suggest you take your regular used pain killer e.g. codeine based drugs or paracetamol avoiding Aspirin). If this does not manage your pain adequately then please contact our 24 hour aftercare line. Sudden onset of severe pain coupled with sweating, feeling faint and a rapid heartbeat within one or two hours of your treatment - please ring the aftercare helpline straight away. 5

Ectopic Pregnancy Awareness If you were in the early stages of pregnancy when you had your treatment (under 10 weeks) it is important that you read the ectopic pregnancy leaflet and follow the guidance given. Typical signs - sharp stabbing pain in the low abdomen which may come and go and vary in intensity and may only be on one side, pain in the shoulder, feeling weak, dizzy and faint, generally feeling unwell and dark vaginal bleeding. This requires you to seek medical attention from your local A&E Department. 6

Antibiotics Please ensure the 4 antibiotics you were given to take home with you are taken altogether as one single dose. If you have any nausea or vomiting, it is sensible to take the antibiotics as soon as your stomach settles within 48 hours of your treatment. Contraception If you have received a tablet form of contraception, you can start to take this the day after your treatment. 7

Getting back to normal A shower is preferable to a bath over the first few days. Use unperfumed soap and water to avoid introducing infection Do NOT use tampons until after your next period We advise not to have sex of any kind for two weeks to avoid the risk of infection Avoid any strenuous activity for at least two weeks, including sports or heavy physical work as this can increase bleeding Avoid swimming for two weeks to reduce the risk of infection 8

Pregnancy Symptoms: It is common to have some breast tenderness for several weeks but if they remain sore after two weeks please call us on the 24 hour aftercare helpline and speak to one of our nursing team Nausea and vomiting should settle after a couple of days and is one of the first symptoms to disappear after treatment 9

Counselling Although most women feel a sense of relief following their abortion, if you find you have unexpected reactions and unresolved emotions then be reassured that this is quite normal. Specialist counselling, on a one to one basis, can help you work through these issues and move forward. If you would like to talk to a counsellor, we can arrange a session as part of our service. You may feel that one session is all you need but if not, further sessions can be arranged with a counsellor; either face to face or over the telephone. To arrange this call: 0845 300 8090. 10

Testing Your reassurance We would advise performing a pregnancy test 4 weeks after your treatment to ensure that it has been successful. We do not advise a pregnancy test before 4 weeks as your pregnancy hormone Human Chorionic Gonadotropin (hcg) levels will not have returned to normal. (NB. this can take up to 6 weeks but generally levels have decreased in around 4 weeks) and the test could give you a false positive result. 11

MY TEST WAS POSITIVE SHOWING THAT I M STILL PREGNANT. WHAT DO I DO NOW? Don t panic! Are you still experiencing pregnancy symptoms? Retake your test again at 5 weeks post treatment and if you still have a positive pregnancy test result call our 24 hour aftercare line. 12

I VE HAD MY INITIAL BLEED BUT I M STILL GETTING PERSISTANT PAIN. IS THIS TO BE EXPECTED? As the uterus returns to it s prepregnancy shape and size this can be quite normal and you are advised to take your pain killers regularly. If you are getting no relief from the pain killers please call our 24hour aftercare line for more advice. 13

I HAVE HAD CONTINOUS BLEEDING FOR 8 WEEKS SINCE MY TREATMENT This could simply be due to a change in your method of contraception. If you still have further concerns please ring our 24 hour aftercare helpline and speak to the nurse who will advise you on a course of action. I HAVE BEEN GETTING SHARP STABBING PAINS IN MY ABDOMEN MAINLY ON ONE SIDE BUT ALSO PAINS IN MY SHOULDER The above combined with feeling lightheaded, and dizzy may be an indication of an ectopic pregnancy and needs to be explored further. Please ring our 24 hour helpline where the nurse can determine whether you need more urgent attention from an A&E Department. 14

I AM STILL PASSING CLOTS AFTER 2 WEEKS. SHOULD THIS BE HAPPENING? Yes, on its own this can be the normal pattern of bleeding. If you have other symptoms or further concerns, please call the aftercare line. 15

IT HAS BEEN 8 WEEKS AND I HAVE STILL NOT HAD A NORMAL PERIOD. IS THIS RIGHT? You need to do another pregnancy test, call our 24 hour aftercare line and discuss the result with a nurse. 16

I HAVE A STRONG FISHY SMELLING DISCHARGE. WHAT DO I DO? You will need to call our 24 hour aftercare line where we will go through some questions to determine whether this is due to an infection. 17

Your Chlamydia test If you had a Chlamydia test but have not received the results within 2 weeks of your treatment please call our test results team on 0845 120 3641. If you have a positive test you may need further antibiotics. Your partner(s) will also need to attend a GUM clinic for treatment. If you have already been given antibiotics make sure you take all the tablets as directed. 18

General travel advice Make sure you have thought about how you will manage possible bleeding and pain during your flight/journey Drink plenty of water - avoid alcohol and caffeine drinks Mobilise frequently during any flight to prevent risk of thromboembolism/blood clots If you experience leg pain, leg swelling, chest pain, breathlessness, dizziness or fainting either during or soon after a flight it is really important you seek emergency medical attention 19

Here at Marie Stopes United Kingdom we take what you think of us very seriously. If you have recently contacted our 24 hour aftercare line and spoke to one of our nurses - we would appreciate if you could take five minutes to tell us what you think about the service provided by completing our online survey. http://ocsurvey.co.uk/ 20

Surgac/rev1/MA/05.14