Abortion care at Homerton

Photograph of entrance to Tuke Ward, Women's Health Centre at Homerton

Getting an appointment for abortion care

You can refer yourself for abortion care at Homerton University Hospital.

Call 03457 30 40 30

To change an appointment - or if you missed an appointment and/or need to be seen further times in the same pregnancy please call us directly on 020 8510 7445

COVID-19 (coronavirus) - impact on abortion services

Like other services and organisations, we have been impacted by the outbreak of Coronavirus (COVID-19)

There are currently no delays in our service but we have made changes so that your first contact with a doctor or nurse will be a consultation by phone (or video-call).

In this consultation we will aim to work out the various options – medical abortion or surgical abortion (or if you are still deciding about your pregnancy then we can support you with that).  Sometimes it will be safe to arrange delivery of medical abortion pills to your home and you will not need to attend the clinic at all.  However, this will not be the case for everyone and you might need to attend to get a scan (and sometimes other tests). Often the scan can be the same day but sometimes we might need you to come a day or two later.

At the moment, because of the effects of the Coronavirus pandemic on hospital services it is harder for us to offer general anaesthesia (you are asleep) for a surgical abortion but where this is really needed it is still available. Surgical abortion under local anaesthesia (you are awake) is still available as normal. Plus we are introducing conscious sedation (this is when a medicine is injected into your bloodstream through a drip to relax you and make you drowsy but you do not sleep).

For general information on abortion see www.nhs.uk/conditions/abortion/what-happens/

General information

Your phone consultation appointment

Eat and drink normally on the day of your consultation. If you have a medical abortion or a surgical abortion under local anaesthetic (awake procedure) we want you to have eaten. Surgical abortion under general anaesthetic (asleep procedure) will not be on the same day as you first appointment.      

Confidentiality

We provide a confidential service to all our patients, (including young people under 16 years old). We recommend that your GP is informed of ongoing treatments or conditions but we would only contact them with your agreement. The only reason why we might have to consider passing on confidential information without your permission, would be to protect you or someone else from very serious harm.  We would always try to discuss this with you first.

Support if you are undecided

If you need more time to consider any aspect of your decision or your feelings about it we will book some more appointments. You should never feel rushed about the decision. You can request pre and/or post-abortion counselling.

Travel after abortion

We would recommend that you do not travel – and certainly do not fly – until a week or two after having an abortion.

Sexually transmitted infections (STIs)

We encourage everyone having an abortion to do testing for common STIs.  Please click on the following link to arrange for a free and discreet postal pack for self-testing www.shl.uk

Contraception

Please consider your contraceptive options. These websites can help you make your choice:

www.contraceptionchoices.org or www.sexwise.fpa.org.uk/contraception

A contraceptive pill can be started the same day or day after you pass the pregnancy.

A contraceptive implant (or injection) can be given when you take the first medicine.

An intrauterine contraceptive can be fitted after it is confirmed the pregnancy has ended; it is recommended to be done soon afterwards.

Choosing between abortion methods

How the abortion is carried out may depend on the number of weeks of the pregnancy and any medical conditions you have. Usually, if you are below 10 weeks you can chose between a medical or a surgical abortion. We will help you decide but you might like to read some of the information below so you know a bit more.

You may find the following information from NICE helpful:
Abortion before 14 weeks: choosing between medical or surgical abortion (Decision aid)

How is a surgical/suction abortion done?

(When less than 14 weeks) this is done using vacuum aspiration or gentle suction to remove the pregnancy from the womb. It takes about 10-15 minutes from start to finish. The treatment can be performed with a general anaesthetic or local anaesthetic. A local anaesthetic means you will be awake for the procedure. A general anaesthetic means you will be asleep (unconscious). The cervix (entrance to the womb) is gently stretched, enough for the contents of the uterus to be removed with a suction tube.

For a general anaesthetic you are in the Day-Stay Unit for about half a day but with local anaesthetic you are in the Women’s Health Unit for a few hours – (see also “Support & Escorts” below). (For pregnancy later than 14 weeks there is another stage in the treatment).

How is a medical abortion done?

You will need to take medication on different days - 24 to 48 hours apart. The first tablet is called Mifepristone. You can have a normal day after this has been taken i.e. you may return to work and/or continue to look after any children in your care. The second medication is Misoprostol tablets and these will bring on pain and bleeding which usually starts soon after the tablets have been given - but for some people it is not until a bit later. You will not be able to work on this day, nor look after any children in your care – see “Support & Escorts” below.

What is the SAME for both medical and surgical?

There is no difference in the risk between a medical or surgical abortion. Neither type of abortion is likely to cause complications in future pregnancies.

What is DIFFERENT for medical and surgical?

All methods of early abortion carry a small risk of failure to end the pregnancy. For a medical abortion this is uncommon, about 1 in 100. For a surgical abortion this is very rare, occurring much less often.

Bleeding is longer after a medical abortion. It is usually heavier than a period and often accompanied by clots. On average, women bleed for 9 -14 days following a medical abortion but some will have bleeding for up to 3 or 4 weeks. After a surgical abortion bleeding will last about 7-10 days. There is pain with a medical abortion and it can be severe, but in most cases is not worse than a bad period pain. For a surgical abortion with general anaesthetic you are asleep during the procedure. You wake-up with little or no pain. For a surgical abortion with local anaesthetic you will feel cramping, similar to bad period pains, during the procedure. For some women it is more uncomfortable.

Support and escorts

For a medical abortion an adult should ideally be with you at home. We like to know that you can get back to the hospital if necessary and that you have a phone. Someone else should be taking responsibility for any children in your care and you will not be able to work the day of the misoprostol.

For a surgical abortion with general anaesthetic you are in the day-stay unit for about half a day and you must arrange for an adult to take you home (your escort) and an adult must also be with you overnight.

For a surgical abortion with local anaesthetic you are in the Women’s Health Unit for a few hours and do not need an escort home.