If you are having conscious sedation or a general anaesthetic it is very important that you do not eat anything (including lollies or gum) for 6 hours prior to your appointment. You may drink small amounts of water only, but no other fluid, up to 2 hours before your appointment. Please inform us when making your appointment if you are a diabetic.

You must not drive a motor vehicle for 24 hours and must have someone accompany you home.

If you are having a local anaesthetic you may have a light breakfast.

If fasting guidelines are not followed your appointment may need to be cancelled or rescheduled.

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It is essential that you bring with you:-

• your Medicare card;
• personal identification (this can be items such as your driver's licence or two credit or bank cards);
• any notes you were given by your GP (a doctor's referral letter is required in the state of Western Australia);
• cash, credit or eftpos card;
• any reports or ultrasound scans of this pregnancy;
• any medication you are currently taking (including inhalers); and
• if applicable, your current concession, healthcare or pension card.

It will make your stay more comfortable if you bring with you:-

• 2 sanitary pads (not tampons);
• a book or magazine to read while you are waiting;
• comfortable two piece clothing (ie. not a dress); and
• a spare pair of underwear.

Other instructions:-

• Have a bath or shower before you leave home.
• Please leave any valuables including jewellery at home. We cannot take responsibility for loss or damage to personal belongings.
• Please do not bring young children or babies with you as it may upset other clients.
• If your arrival is delayed for any reason please call in advance to let us know.
• Marie Stopes International maintains a non-smoking policy.

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It is very important that you are aware you could conceive as early as 2 weeks after your abortion/pregnancy termination. We therefore strongly advise that you decide on a suitable contraceptive method as quickly as possible. We are happy to discuss the various contraceptive methods available to you.

For more information, download a copy of the Abortion: Your Questions Answered (if you do not have Adobe Acrobat Reader, you may download it from www.adobe.com).

Contact our National Support Centre toll free on 1800 003 707 and one of our staff can give you details of charges and methods of payment. Please note we do not accept cheques, AMEX or Diners Club cards.

If you have private hospital cover, you may be able to claim back part of the fee. Please check this with your private health fund prior to attending the centre. If a partner, family member or friend is paying your fee by credit or debit card they must accompany you. We are unable to arrange payment by telephone.

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All interactions between Marie Stopes centres and you are confidential. We will discuss this with you and will only contact your GP if you request us to do so. In Western Australia however, we will need a referral from a GP.

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This is entirely up to you. If you have a physically demanding job you may want to take a few days off. A lot of women return to work on the day following an early abortion/pregnancy termination.

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If you want to talk to someone about your experience and how you are feeling, there are experienced post-abortion counselling agencies available. A Marie Stopes International team member can refer you to an experienced counsellor, or phone Freecall 1800 003 707 and we can give you the details. The cost of post-abortion counselling varies. Some agencies are government funded with no fee, and some charge a minimal cost for post-abortion counselling.

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The majority of women feel that talking through their feelings with their partner, friends, family or doctor is usually all that is needed. However, some women may not have anyone they can easily talk to, or they may think that others will pass judgement, and therefore feel very isolated, at a time when support from others is needed. By acknowledging and accepting unexpected reactions and unresolved feelings towards the abortion, most women find they are able to work through these in a positive way. This is where post-abortion counselling can help.

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For many women, making the decision to seek help regarding abortion is relatively straightforward. However, for others abortion is an issue that is fraught with complexities, and the decision to undergo the procedure causes much anxiety. While most women feel relief following an abortion and are able to move forward, some may feel a sense of loss or sadness and can experience the following:-

• numbness and emptiness
• false euphoria
• the need to keep excessively busy
• general depression
• sudden bouts of crying
• anger and/or guilt
• sexual or relationship difficulties

Whether or not you seek post abortion counselling is a decision for you. You will be able to discuss it with one of our team members on the day of your procedure or afterwards and we will be able to provide you with details of further counselling services.

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You may experience some period-pain like symptoms which are best treated with painkillers.

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Early abortion/pregnancy termination is one of the safest procedures carried out in hospitals and clinics throughout the world. There is very little risk associated with abortion, particularly in early pregnancy.

There are, however, a small number of possible complications which you need to be aware of. The most common risk associated with abortion is infection after the procedure. This can be reduced by following the aftercare instructions you will be given when you attend for treatment, including not using tampons or having vaginal intercourse for about two weeks after your treatment. We will also offer you a test for a common cause of infection, Chlamydia. If you decide to have this simple test and the result is positive, you will be prescribed appropriate antibiotics.

The most serious risk is that damage may be caused to your uterus during the course of the procedure, a risk which is greater in later pregnancy. Although the risk is extremely small you need to be aware of it. Your treatment will be carried out by an experienced doctor and every effort is made to minimise risks. In early pregnancy (usually 6 weeks and under) there is a risk that the pregnancy may be missed completely because it is so small. We may recommend that 2 to 3 weeks after your treatment you have a repeat pregnancy test to ensure all is well.

A pregnancy test carried out less than 2 weeks after your treatment is not reliable.

Please do not hesitate to contact us if you are concerned you are still pregnant. There is also a small risk of incomplete abortion at any stage of the gestation. This is where a tiny piece of tissue has not been removed and causes prolonged bleeding and pain. If this happens it is important to seek help as quickly as possible to decrease the risk of an infection developing. Should this happen we are always available to provide follow up care.

There is very little risk associated with abortion, particularly in early pregnancy. Despite claims to the contrary, there is no evidence to suggest that a straightforward abortion has any affect on future fertility nor any other aspect of general health.

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As our waiting rooms are not overly large, we ask that you limit the number of people accompanying you. Please note that we are unable to accommodate young children or babies. In consideration of other clients we are unable to allow visitors into the recovery and theatre area during your stay.

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This depends on your anaesthetic choice. it may be longer if you have a general anaesthetic. You may leave as soon as you feel well enough, and we suggest that you have someone to accompany you home. An approximate timeframe in the centre is around four hours.

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Following treatment you will spend a short time recovering in a reclining chair or bed. Unless you have any unusual pain or discomfort, you will not be examined before leaving as it is both unnecessary and uncomfortable so soon after treatment. You will receive a leaflet about aftercare which gives you advice about the symptoms you may experience following treatment, and what to do if you are at all concerned.

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Most women who choose not to have a general anaesthetic report that the discomfort is bearable and lasts only for a short time. A few of our clients report more severe discomfort, but again the discomfort is only brief. Even with a general anaesthetic there will be some cramping pain following the procedure. Painkillers are available if they are required.

You have three anaesthetic options. All the options will be fully explained during your consultation enabling you to make an informed choice:-

Local Anaesthetic:

Depending on your stage of pregnancy you can choose to have your procedure under local anaesthetic. Marie Stopes International pioneered this service in the UK. You may wish to consider this as an option as recovery is quicker and safer than a general anaesthetic.

Conscious Sedation:

The advantage of conscious sedation as an alternative to a general anaesthetic is that you will be awake during the procedure and your recovery time will be speedier. You will feel drowsy and relaxed during the procedure.

General Anaesthetic:

During a general anaesthetic you will be under unconscious sedation and completely asleep.

If you choose to go under sedation or general anaesthetic you must not drive for 24 hours.

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A doctor who has been fully trained and experienced in performing these procedures will perform your termination of pregnancy. All Marie Stopes International doctors specialise in abortion and family planning.

Here is a brief guide on how a termination of pregnancy is performed:-

Surgical abortion up to 12 weeks:

At this stage gentle suction is used to remove the contents of the uterus. As the procedure takes less than 5 minutes you may choose to have a local anaesthetic or you may select to go under general anaesthetic or conscious sedation.

From 13 weeks onwards:

The procedure at this stage of the pregnancy will take slightly longer as the doctor needs to dilate the cervix in order to remove the contents of the uterus. Please call our National Support Centre for more information on the abortion services provided at each centre.

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There are several blood groups including A, B, AB, O and some others which are more rare. Blood is also either rhesus positive or rhesus negative. The rhesus type you have is dependant on the blood group of your parents. When a woman who has rhesus negative blood carries a rhesus positive pregnancy in her uterus, the blood cells from her pregnancy can enter her blood stream. Her immune system will treat the blood from the foetus as foreign and will respond by making antibodies, which will destroy the blood cells of the foetus.

By giving an injection of rhesus antibodies known as Anti-D, the woman's immune system is prevented from making antibodies against future pregnancies. Only women who are a rhesus negative group will receive an Anti-D injection, this is given straight after an abortion or after a full term pregnancy.

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An ectopic or tubal pregnancy is a pregnancy that is situated outside the uterus, usually in one of the fallopian tubes. As this area is so narrow, an ectopic pregnancy cannot develop normally and can cause a rupture. If there is any chance that your pregnancy may be ectopic you will be referred to a hospital facility for further treatment. Unfortunately, ectopic pregnancy can be very hard to detect with an ultrasound scan, which often gives every appearance of a normal pregnancy. It is therefore very important to be alert to the signs that may indicate an ectopic pregnancy, such as one sided pain or tenderness and/or bouts of dizziness.

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The purpose of an ultrasound is to determine how many weeks the pregnancy has progressed (your gestation period) and to ensure that there is a pregnancy in the womb. The scan is not intended for diagnostic purposes. If the nurse or doctor performing the ultrasound is concerned about anything out of the ordinary they will advise you to see your own doctor.

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Once you have completed the necessary administration requirements, you will have a consultation with a nurse or doctor. When you are sure of your decision, the nurse/doctor will provide you with information regarding the procedure, including your anaesthetic options. The nurse/doctor will discuss with you your medical history and will also discuss various contraceptive methods available to you for future use.

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We are occasionally subject to demonstrations by anti-abortionists. They usually take the form of a few people gathered outside trying to dissuade our clients from entering the centre. Although these people have no right to interfere with your legal or moral right of choice, we cannot prevent them protesting unless they break the law. We do understand how traumatic this may be and stress that you do not enter into any conversation with these people. Note that they cannot prevent you from entering our centres.Try not to let them distress you and walk calmly past. There will be a member of our team to help you once you are inside the centre. If you are concerned and wish to discuss anything, please call us.

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Counselling is available to any woman who feels she needs to discuss her situation or who may be unsure about her decision. If you would like to speak to an experienced counsellor prior to your consultation please phone us on TOLL FREE 1800 003 707 and we can give you the details of counselling agencies to contact.

If you feel comfortable with your decision, you may not feel you need counselling. It is entirely your choice.

Clients in the state of Western Australia are required by law to obtain a doctors referral prior to an appointment at Marie Stopes International. It is a legal requirement in WA that your doctor discuss with you the risks of termination and the risks associated with continuing your pregnancy.