• Reference Number: HEY-286/2016
• Departments: Gynaecology
• Last Updated: 1 April 2016

Introduction

This leaflet was produced to give you information about counselling and support services available, if you are considering the termination of your pregnancy. This leaflet explains what support is available to you and how to access it. The leaflet also provides information about the emotional impact of a termination and answers some frequently asked questions.

Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your nurse/doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the team caring for you.

Making the decision

Whilst some women have very definite views about their unplanned pregnancy others describe feeling uncertain and confused, as if their head is telling one thing and their heart another. If this is the case for you then one of our support staff may be able to help.

The support staff are trained nurses, social workers and counsellors who will give you time to help you consider your options, so that you can chose the best decision for you.  The Support staff will:

• Listen to you
• Ensure that you have all the information you need to make your decision
• Help you decide what you want to do
• Assist you if you need to access counselling before, during and following the termination

Post-termination support

Following a termination, women can experience a variety of emotions and feelings, some of which may appear contradictory. Although you may have chosen to have a termination, it can sometimes be a confusing and painful emotional experience afterwards. You may feel relieved but also quite sad.

Sometimes there are feelings of loss but these normally decrease with time. It is important to remember that all women are different and there is no standard amount of time that it takes for a woman to put her termination experience behind her.

After your termination, you may want to talk to someone who will listen and understand and it is often easier to talk to someone disconnected from what has happened rather than friends or family. If this is so, then our counsellors may help.

The Counselling Service offers short-term counselling to support women before, during and following the termination. Your counsellor will listen to you with respect and without judging you. They will not offer you instructions or solutions. They will offer you time, space and use their professional skills to help you explore your thoughts and feelings so that you can deal with the problems you are facing now. Counselling may help you through a difficult time and enable you to manage again.

The Counselling Service is based in Hull and most counselling sessions take place there. However, it is possible to access an alternative venue if you cannot attend Conifer House. You will have an opportunity to discuss this with your counsellor before counselling is offered.

How to contact the Counselling and Support Service

If you need support to make a decision about termination of pregnancy then discuss this with your health worker at the time your pregnancy is confirmed.  They will then access a counsellor in the clinic during your care.

If you need to meet with a counsellor you can either:

• Inform nursing staff at the hospital or clinic you are attending for your termination; or
• Following your termination, contact the Counselling Service direct by telephoning our confidential answer phone on (01482) 844038

Some frequently asked questions:

How will I feel after the termination?

Feelings following termination depend upon the individual person and their circumstances. After a termination, some women feel a sense of loss, even when they believe their decision was right. Others may feel relief. There is no evidence that termination causes long term depression or trauma, providing the procedure was your choice. However, some women find that the fluctuation in their hormone levels following termination does result in mood changes. It is therefore common for women to feel sensitive and irritable whilst the hormones levels in their bodies adjust.

Initially you may feel a sense of relief and then later other feelings may include

• sadness
• emptiness
• numbness
• grief
• guilt and shame
• anger
• sense of loss
• depression

Some women experience other problems, such as:

• being unable to be near pregnant women or young babies
• tension in their relationships
• bad dreams or nightmares
• wanting another baby straight away
• avoiding baby pictures in magazines or on the television
• loss of self esteem
• preoccupation with the termination

These are common problems, which usually subside with time. However it is important that you seek help if you think they are becoming unmanageable for you.

What if I change my mind?

Remember, even if you have booked a date for your termination you can still change your mind right up until the procedure is started. In the case of a Medical Termination this means until you have taken the oral tablet. In a Surgical Termination it means until you are prepared for the procedure, either the day before, or on the ward on the day of the operation. If you do change your mind it is important that you tell a member of the nursing staff as soon as possible.

Should I tell my friends and relatives?

You may need time to think about whom to tell. You may benefit from sharing your feelings with friends and relatives, however the choice is yours and you may prefer to keep these thoughts to yourself.

How soon can I have sex afterwards?

Vaginal penetration should be avoided for two weeks or until bleeding stops. This may be a time when you and your partner discover other ways of fulfilling your sexual needs. If you find it impossible to wait, use a condom to help prevent infection.

Will I feel differently about sex?

There are no reasons why a termination will necessarily affect your feelings about sex, but if contraception has failed, this in itself might make you feel insecure and worry about further unplanned pregnancies. You will have an opportunity to discuss future contraception before you leave the hospital.

The termination is affecting my relationship, what can I do?

It can be very difficult to cope with an unplanned pregnancy, particularly if you both have different expectations from your relationship. One of the hardest situations can be when there is a difference of opinion over continuing the pregnancy. It may be helpful to seek professional help if you find that your relationship is suffering. Relate offer counselling to couples experiencing problems in their relationship. They can be contacted locally on (01482) 329621.

If you think that you might prefer to discuss your problems on an individual basis, then you can discuss the availability of counselling with your GP.  Alternatively, contact the Counselling Service at Conifer House for information on services available locally.

Will the fetus feel any pain?

The stage at which a pregnancy is terminated by the hospital is too early in the development of the fetus for pain to be experienced.

Will I know the sex of the fetus?

No. The method of termination and the stage at which it is carried out in the hospital means that it is impossible to determine the sex of the fetus.

I still have lots of unanswered questions – who can I ask?

There may be questions you did not ask at the clinic, or questions you have thought of since. If these questions are playing on your mind then you are welcome to ring the service. If your question cannot be answered on the spot, we will get back to you. You will find the contact details for Conifer House below:

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Gynaecology Department on tel: Gynaecology Outpatients (01482) 607829 Women and Children’s Hospital Counselling Services (01482) 844038

The Hull and East Riding Sexual and Reproductive Health www.conifersexhealth.co.uk

Family Planning Association www.fpa.org.uk

British pregnancy Advisory Service Tel: 08457 304030 www.bpas.org.uk

Marie Stopes Organisation Tel: 0845 3008090 www.mariestopes.org.uk

Royal College of Obstetricians and Gynaecologist www.rcog.org.uk

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.