Following a discussion with the clinic staff you have opted to have outpatient medical termination of pregnancy.
Choosing to terminate a pregnancy can be an emotionally difficult decision. This leaflet aims to provide information about this process and what to expect before, during and after the process you have chosen.
What will happen?
Written consent will be taken in the clinic.
A date for treatment will be agreed upon, this is usually on the day of your consultation. Occasionally we may ask you to return at a later date for treatment to begin. You must have a responsible adult with you on the day of your home management.
You will be given a tablet called Mifepristone to begin the process, this is taken orally. Some women may experience bleeding after taking this tablet; if the bleeding is like a period, do not worry. If the bleeding is heavier and you are worried or are experiencing pain please contact the department on the number at the end of this leaflet.
We will provide you with a medication pack to take home with you. The pack contains:
- Misoprostol - which will soften your cervix and cause your uterus to contract
- Metronidazole – an antibiotic to help prevent infection
- Codeine Phosphate - to help manage your pain through this procedure.
We recommend that you purchase and take:
- Paracetamol - 1g every 4-6hrs, no more than 8 tablets/24 hrs
- Ibuprofen – 400mg every 6-8hrs, no more than 3 tablets/24hours
Please inform us if you have any drug allergies.
At home
On the morning of your agreed treatment date insert the Misoprostol (4 tablets) vaginally using a tampon. The tampon is to be removed after 1 hour. If you are unable to use tampons the tablets can be inserted in to the vagina using your finger.
This medication will cause strong period like cramps. You will experience bleeding, which is likely to be heavier than a period with large clots. Please take the 2nd dose 3hrs after the 1st dose. If the bleeding is heavy you may take this 2nd dose orally. This process may take several hours, use pads not tampons. Some women may experience sickness and diarrhoea. The bleeding and pain eases once the pregnancy tissue has passed. Depending on how far on you are in your pregnancy it is possible you may see pregnancy tissue or a small foetus pass.
Although we expect you to have a heavy bleed, if the bleeding is prolonged i.e. soaking 3 or more pads in an hour for more than 2 hours or if you begin to feel faint, dizzy or unwell you should contact the department immediately for advice.
If you have any concerns about what to expect please discuss this with your Doctor or Nurse.
You can contact the department at any point throughout the day if you need advice.
Bleeding
It is normal to bleed for 2 to 3 weeks following this procedure. You should use pads and not tampons during this time. If your bleeding is heavy, please contact Women’s Outpatients Department.
Pain
Some women experience some mild to moderate pain in the days following the procedure; it is usually relieved by Paracetamol & Ibuprofen. . If the pain becomes more severe please contact Women’s Outpatient Department.
Infection
To reduce the risk of infection please use pads rather than tampons and avoid intercourse for2 weeks.. If you develop a smelly discharge it is important you contact your GP advice.
Contraception
We will have discussed contraception with you. Please follow the advice given for your chosen method.
Emotions
It is not unusual to feel low in mood following a termination of pregnancy. If you are struggling to cope with these feelings in the coming weeks and months, be kind to yourself, accept support from friends and family, please contact your GP for further help and support.
**Please check an early morning urine pregnancy test is negative 3 weeks after treatment. Contact the department if it is positive**
Useful telephone numbers & websites
Cumberland Infirmary
Women's outpatient department
Mon - Fri 08:00 - 17:00
01228 814264
West Cumberland Hospital
Women's outpatient department
Mon - Fri 08:00 - 17:00
01946 523211
Out of Hours - for emergency use only
01228 523444 - ask for the gynaecology doctor on call - bleep no. 2800
Solway Clinic 01228 608989
British pregnancy advisory 08457 304030
**Any unused misoprostol must be returned to a pharmacy. Please DO NOT flush down the toilet or put in household rubbish**
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302