• Reference Number: HEY-771/2023
• Departments: Gynaecology
• Last Updated: 27 October 2023

Introduction

The Pregnancy Advisory Service (PAS) is a confidential service and any information disclosed during your visit will not be shared unnecessarily.

This leaflet has been produced to give you information about what to expect at your outpatient consultation.  It is not meant to replace discussion between you and your doctor or nurse, but can act as a starting point for discussion.

Although this document refers to the term woman/women, it is applicable to anyone that can become pregnant regardless of whether you identify as a woman or not.

We will try to contact you by telephone to pre-assess you and collect relevant information ahead of your face to face appointment and offer any advice about your attendance. If this is not convenient please inform us and we can complete this in clinic. It will not impact on your treatment.

We need to include emergency contact details for you so that we can get in touch with you, for example, if there are any abnormalities in your test results.

Upon arrival in the department

You will be welcomed to the department by a Support Worker or a Clinical Support Worker (CSW). You will have your height, weight, temperature and BMI (Body Mass Index) recorded.

Do I need an ultrasound scan?

It will be necessary for most women attending the clinic to undergo an ultrasound examination unless you have had one recently. This is used to determine how far on you are in your pregnancy which is important in your decision making and to help us plan treatment for you.

The scan is usually performed vaginally (like having an internal examination), or abdominally, by gently running a probe over your abdomen.

What happens when I see the PAS nurse/doctor?

In the Gynaecology Outpatient Department (GOPD) you will see a Clinical Nurse Specialist (CNS) who will co-ordinate your care throughout your outpatient visit.  This appointment could last approximately 3 hours.  You will be shown to a consulting room where the nurse will recheck your personal details and ask you a variety of questions relating to your general health and wellbeing.

The aim of asking these questions and carrying out these tests is to ensure that staff have all the relevant details needed for you to receive the appropriate and safe care that meets your individual needs.

Once you have had an ultrasound scan if required, you will be seen by the PAS CNS/doctor.

This consultation usually involves the following:

• Asking questions about your health (physical, emotional and sexual history, past and present)
• The reasons for your attendance at the clinic today
• Contraception details
• Possibly a physical examination (‘internal’ or ‘vaginal’) for which you will be asked to undress
• A swab may be taken. If the results of the swab indicate a serious infection, you will be contacted on the telephone number you have provided and given details about any treatment that is needed.

Please note, if the doctor or nurse who referred you to the clinic has already taken swabs, these will not need to be repeated.

The PAS nurse/doctor will discuss your request for termination of pregnancy and the options.

Provided there are legal grounds for the termination within the Abortion Act (2010) and you are very sure this is what you want, the doctor will arrange this for you.

Your doctor will provide you with both verbal and written information about the methods of termination and the risks involved.  The method of termination offered will depend upon how far on your pregnancy is, your wishes, your health and what services are available.

Contraception will also be discussed, as it is essential that the provision of effective contraception is an integral part of your care. You will also be consented for your termination of pregnancy procedure: however this does not mean you cannot change your mind at a later date about what you want to do.

What happens after the doctor’s consultation?

If the decision has been made to perform the termination, before you leave the clinic, the CNS will see you again and will complete the pre-admission assessment.  This may include taking a blood test to determine your blood group and haemoglobin level; this is to check you are not anaemic.  The nurse will also ensure that you have been given a date for your procedure or if you need to come into hospital as an inpatient, and discuss the procedure further.   You may be given an antibiotic and advised when to take it; this is to protect you against infection.

You will be given open access via telephone contact on discharge if you experience any problems following your procedure. Follow up care will be arranged if this is required.

Gynaecology Outpatients, Mon to Fri 08:00 – 17:30 (01482) 607829

Emergency Gynaecology Unit, Saturday and Sunday 08:00 – 15:30 (01482 608767)

Cedar Ward/Ward 30 out of the above hours (01482 604387)

How can I access counselling?

As well as seeing a nurse and a PAS nurse/doctor as part of the consultation, you will also be offered the opportunity to discuss your needs and concerns with a counsellor. Please let the nurse or doctor know if you would like a referral to the counselling service.

Sexual health screening

During your consultation with the PAS nurse/doctor, you will be offered a sexual health screen where a self-swab is obtained to rule out infection.  This is very important because an undiagnosed infection can lead to serious complications.

Further advice

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.