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Consultation

(including telephone consultation)

If you have a NEW cough and or a high temperature (above 37.8 degrees) you must self isolate for 10 days. If your clinic appointment with us is within your 10 day isolation period, please call us to rebook.  For safety, please do not attend your appointment at the clinic, you will not be treated if you have these symptoms and you will be rebooked. Visit NHS 111 for more information and advice.

Consultation appointment

During the Covid-19 outbreak women will routinely have a telephone consultation with a nurse rather than a face to face consultation in the clinic. When you do attend a clinic you cannot bring an escort with you unless:

  • you are aged under 18
  • you are a prisoner
  • you need physical help, or lack the mental capacity to decide

Everything you tell us is kept private. Doctors, nurses and health workers cannot share information about you without your agreement unless they think that you or another person is in serious danger. In these exceptional cases they would try to discuss it with you first.

Some or all of these steps may be needed before we begin your treatment, but they might happen in any order:

VIDEO: What happens before your treatment

Telephone consultation

Most women will have a telephone consultation appointment lasting around 40 minutes. During this you need to be on your own, somewhere safe where you can speak openly.

 At the beginning of the call we confirm your personal information and ask some security questions. We then talk about your pregnancy options and if you decide to end the pregnancy we undertake your medical assessment, discuss your treatment options, book your treatment and formally consent you for treatment. We also talk about your future contraception needs and STI testing.

Although your treatment booking is based on the information given during your telephone consultation, an ultrasound scan may be necessary (on the day of treatment) to confirm that your treatment can go ahead.  You may need a finger prick blood test before treatment begins. We check the information discussed over the phone with you and confirm your consent to treatment.

Pregnancy options discussion

VIDEO: Pregnancy options discussion

You will be seen on your own to talk privately about the pregnancy and decide whether to:

If you still feel unsure, need more time to come to a decision or want to speak to a counsellor in depth, we can arrange this when you call to book.  If you want to end the pregnancy we will begin your medical assessment.

Medical assessment

VIDEO: Medical History & Examination

To ensure that treatment is suitable and safe for you, we may need to carry out some tests. We will:

  • Ask you about your medical history
  • Check your weight and height (only if necessary)

If you attend at our clinics we may

  • Give you an ultrasound scan on your tummy (if necessary)  (for early pregnancy a small probe may be placed in your vagina)
  • Take your temperature

Ultrasound scan

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VIDEO: Ultrasound

You may need an ultrasound scan to date the pregnancy and confirm that your planned treatment is suitable. Sometimes the pregnancy is so early that we cannot see it on an ultrasound scan on your tummy, so we may need to insert a small ultrasound probe into your vagina.

If we can’t see the pregnancy on a vaginal scan, we cannot be sure that the pregnancy is developing inside the uterus (womb). On rare occasions this may indicate an ectopic pregnancy (where the pregnancy grows outside the uterus).

If a miscarriage is suspected, we will discuss your thoughts and options and provide information about your care.

Blood test

VIDEO: Blood testing

If you are not sure if you have rhesus negative blood, we will check with a finger prick blood test. If you have rhesus negative blood you will be advised to have an Anti-D injection following your treatment. 

We may need to check for anaemia through a finger prick test, and occasionally require a blood sample for other tests.

Pregnancy remains

After a surgical abortion or a medical abortion from 10 weeks gestation, the pregnancy tissue is collected and stored separately from other clinical waste, before being sent for incineration (burning). It is destroyed completely. Your pregnancy remains may be collected together with others in a shared receptacle for disposal. If you would prefer that your pregnancy remains are collected separately, please tell us before your procedure. If you have any specific wishes about how you would like the remains to be disposed of (such as burial or cremation) please discuss this with a member of staff before your treatment takes place.

If you have an early medical abortion (up to 10 weeks gestation), you will pass the pregnancy remains at home or another place of your choosing. You can decide how you wish to dispose of the pregnancy remains. They can be flushed down the lavatory, or wrapped in tissue, put in a small plastic bag and placed in the dustbin. If you plan to bury or burn the remains, ask a member of staff and they will give you some information how you can safely do that. If you prefer you can arrange to bring the remains to a BPAS clinic and our staff will dispose of them for you in the same way we would following a surgical abortion.

If you have any other questions about the disposal of pregnancy remains, please ask.

STI test

VIDEO: STI Testing

STI screening at BPAS is temporarily suspended and you will be signposted to free/online services. If you have symptoms that suggest you may have an STI, please visit your GP or GUM /Sexual Health Service before attending your BPAS appointment. Please visit www.nhs.uk or call the NHS National Sexual Health Helpline on 0300 123 7123 for information on local STI testing and advice in your area.

Contraception

We will discuss your contraceptive options during your telephone consultation.  You can get pregnant almost immediately after an abortion, so it is important to have your method of contraception ready. Almost all contraceptive methods can be started on the same day as treatment if you have a surgical option, and as soon as the pregnancy has passed if you opt for medical treatment. Regretfully, the contraceptive options we can offer you during the Covid-19 outbreak may be limited.  We can supply a combined hormonal contraception method (pills, patches and rings), or progesterone only pill (minipill or POP) along with abortion pill treatment by post, providing you can supply a blood pressure measurement from within the last year during your telephone consultation. If you are attending one of our clinics we can check your blood pressure in clinic and supply you with a more extensive choice of methods. You can ask all the questions you need during your telephone consultation. Click for detailed information on your contraception options.

Choose your treatment

During the COVID-19 outbreak, if your pregnancy is up to 10 weeks' gestation you will most likely be offered abortion pill treatment (unless it is not safe or suitable for you to complete the treatment at home).

The type of treatment you will have depends on how many weeks pregnant you are and the results of your medical assessment. We will answer your questions and help you choose your preferred treatment type. We will then arrange for your treatment. If you are having the abortion pill up to 10 weeks you will most likely take the first medication immediately after consultation.

Consent

VIDEO: Consent

We will explain the known risks and complications of any treatment that is offered to you.  All of your questions are answered.  You will need to verbally consent to indicate that you understand the potential risks of your treatment and the nurse will sign to consent to treatment on your behalf.