Pregnancy

Where can I go to get a pregnancy test?

The quickest way to get a pregnancy test is to buy over the counter pregnancy testing kits from any pharmacist (if you get a positive test result attend your GP or Family Planning Clinic).

Attend your local Family Planning Clinic, (nearest to Oxford Brookes is The Alec Turnbull Clinic, 1st Floor, Raglan House, Between Towns Road, Cowley, Oxford OX43JH Tel: 01865 456666), provide a urine sample for testing and be given the result of your pregnancy test there and then. The Family Planning staff are highly trained and provide support, information and advice at every consultation.

See your GP or Practice Nurse. At Brookes Medical Centre Tel: 01865 483193 all medical staff are highly trained in family planning and provide support, information and advice in every consultation. Your GP is the gateway to further services.

If you have any queries please phone the Practice Nurses Tel: 01865 483193

How soon after conception is a pregnancy test effective?

Over-the-counter home pregnancy kits provide privacy and fast results. Brands vary with the earliest detecting pregnancy three days before a missed menstrual period. Others can detect pregnancy on the day your period is due. However, although tests CAN detect a pregnancy at the time your period is due, if the test is negative then you should repeat it after a few days.

How do pregnancy tests work?

All pregnancy tests are based on the presence of a hormone, human chorionic gonadotropin (HCG), that the pregnant woman produces after conception.

Today's brands, contain monoclonal antibodies that detect minute traces of HCG. These antibodies are molecules coated with a substance that bonds to the pregnancy hormone, if it's present, to produce either a positive or negative result. (Each test manufacturer uses a different "trade secret" chemical formula for the bonding substance.) Your urine is combined with the antibodies provided in the package. The test is timed, and a colour change indicates the result.

How accurate are home pregnancy tests?

Most manufacturers are highly accurate (99%) However, the procedures outlined in the instructions must be followed exactly for results to be accurate. Some of the newest one-step brands, gives results in three minutes and informs you when the test hasn't been done properly. This new testing method, called rapid assay delivery system, combines a biochemical process with monoclonal antibodies in one pen-like instrument.

Should I repeat the test?

Whatever the result or the brand used, most manufacturers recommend repeating the process a few days later to confirm the results.

After conception, a woman produces a minimal amount of HCG. The strength of each test varies, and although a woman may be pregnant, the test may not pick up the amount of HCG hormone present the first time.

We would recommend that it is better to see your Doctor or attend The Alec Turnbull family planning clinic, if you think you are pregnant, and sooner rather than later as you do not want to add to the delay in getting expert help, advice and information.

Positive Test?

If you are pregnant then you have three choices:

Continue the pregnancy and keep the baby
Continue the pregnancy and place the baby for adoption
End the pregnancy now by having an abortion

How do you feel about being pregnant?

An unintended pregnancy can arouse many different feelings. Most women find they have mixed or conflicting feelings. For example, you might feel:

Worried about being able to cope with a baby
Afraid you'll have to give up other things that are important to you
Concerned about how other people may react

At the same time, you might also feel:

Happy to learn that you can get pregnant
Pleased to have the opportunity to have a baby
Excited by a new and unique event in your life

If your feelings are mixed and uncertain it might be useful to think through your plans and hopes for the future and ask yourself what are two or three things that matter most to you in your life at the moment? Also to ask yourself what are the two or three things that you hope to have achieved in the next five or ten years?

The British Pregnancy Advisory Service provides a useful framework of questions to help you think things through.

Unplanned Pregnancy?

Discovering you are unintentionally pregnant can be very difficult and distressing. Every year, some students find themselves pregnant and faced with having to make a decision, often in the middle of an academic term. It can be very important for you and / or your partner, to find a safe, non - judgmental place to talk things through. Nurses, Doctors, Health Visitors, University Counsellors, Personal Tutors are all professionals able to offer you support and information.

It is a situation that any sexually active student could find herself in. Contraception sometimes fails and so it is possible for women to conceive even when they have taken measures to prevent it.

We do however, urge all students to seek contraceptive advice before they become sexually active, to ask for Emergency Contraception (The Morning after pill) - if their contraceptive fails them or they fail to use one and NOT to consider termination of pregnancy as a method of contraception.

Every year women in Britain decide to have an early termination of pregnancy (abortion), often because the pregnancy is unplanned and unwanted. If you think you may want a termination of pregnancy you should make an appointment with your GP or Family Planning Clinic. Early termination (abortion) procedures are usually simple and safe. If you decide to end the pregnancy two doctors will need to confirm you have legal grounds for an abortion. One of the Doctors will be the hospital doctor.

Abortion is legal up to 24 weeks, and in some circumstances after then, but the methods used in later abortions will be different to those in early pregnancy (see below).

Referral for a termination

Your GP or Family Planning Doctor can refer you to a gynaecologist at the John Radcliffe Hospital. This is an NHS service. (NB International Students who are on courses lasting less than 6 months see www.sbmc.org.uk/internat.html).

Organisations such as the British Pregnancy Advisory Service and Marie Stopes International provide private terminations for which they make a charge

The doctor estimates the gestation of your pregnancy by counting the number of weeks since the first day of your last period (i.e. how many weeks pregnant you are)

Within The NHS, a first appointment will then be made for you to be seen at the hospital by a gynaecologist. This first appointment is for an assessment only and not for the actual procedure. Information leaflets are available at your Health Centre/GP and the Family Planning Clinic and are about the different methods of termination available. The methods depend on the stage of the pregnancy.

If you have any doubts about having a termination PLEASE talk it through with any of the following professionals: the Counsellors, Nurses, Doctors, Health Visitors or the specialist Counsellor at the Women's Centre (if you are having a termination within Oxford system). They are there to help you look at all the options so that you can make the right decision for you. You can ask to see them at any stage.

The assessment and what to expect

The assessment is held at The Women's Centre, John Radcliffe Hospital, Oxford

You will be asked a variety of questions by the gynaecologist, about the pregnancy and your general health.

An internal, vaginal examination will be carried out

The gynaecologist takes a vaginal swab to test for a bacteria called chlamydia which can cause an infection after the termination. If chlamydia is present, it is readily treated with antibiotics

You will be asked to give a blood sample to establish your blood group and to check for anaemia. (Women whose blood group is Rhesus Negative are advised to have an injection of anti-D after the termination)

If there is any doubt about how many weeks pregnant you are, the gynaecologist will arrange for you to have an ultrasound scan (a simple procedure providing an accurate picture of the pregnancy)

The different methods of termination will be discussed and the most suitable choices fully explained. The method chosen depends on how many weeks pregnant you are.

A legal form will be completed
A date will be given for the procedure
The staff will ask who will be taking you home from the hospital after the procedure

Methods of termination

Before 9 weeks gestation

Early Medically Induced Abortion

It is possible to have a termination of an early pregnancy without an operation. It involves two visits to the hospital

The treatment involves:

Visit 1: Medical assessment (see above) NB treatment will not start the same day
Visit 2: Taking a tablet called RU486 also known as Mifepristone or Mifegyne. RU486 (Mifepristone or Mifegyne) can be taken up to 63 days or 9 weeks after the start of your last period. RU486 blocks the action of the hormone progesterone which makes the lining of the uterus or womb hold onto the pregnancy and takes two days to work. An appointment will be made for you to return to the hospital 2 days later. During this time you might experience increased nausea, start to bleed vaginally or have period like pains. There is a small chance that the miscarriage will occur during this time. If you do start to bleed, use sanitary pads not tampons. The two days between visits can be spent in the normal way - at home or lectures
Visit 3: Prostaglandin tablets are placed into your vagina. They relax the cervix (neck of the womb) and make the uterus (womb) contract: They are usually felt as strong period -like pains. This is like a miscarriage. You can have pain killers if you need them. Most women miscarry within 4-8 hours of the tablets being given with bleeding and passing some large clots of blood and tissue from the vagina. It is not necessary to lie down or go to bed so take something to do and wear comfortable clothes. You will need to take sanitary pads in to hospital with you. Do not use tampons until your next period
Once the bleeding has settled down you will be re - examined. If all is well you can go home providing that someone can take you and that there is someone to stay with you at night
You may continue to bleed for up to two weeks and some women will have a slight blood loss until their next period starts. If you have quite a lot of bleeding you must see a Doctor as soon as possible as you may need a D&C. The staff on the day unit can also advise you Tel: 01865 222001/2

NB: About 5 in 100 women treated in this way need to have a follow up minor operation (D&C) to stop continuing bleeding which is a result of tissue being left behind in the womb

Do not have sexual intercourse until the bleeding has stopped. And use an effective form of contraceptive. The Medical Centre or Family Planning Service provide a comprehensive range of contraceptives. Contraceptive pills or injections can be given to you while you are in hospital.
You will need to have a final check up 2 weeks later with your GP OR Family Planning Clinic to check that everything is back to normal
You may feel low for a time after the termination, but as your body returns to normal this should settle. If you feel upset it often helps to talk to someone about it and the Doctors, Practice Nurses, Health Visitors, Tel: 01865 483193; Brookes counsellors Tel: 01865 484650; or the specialist counsellor at the Women's Centre Tel: 01865 221235 (if you have had your termination within the oxford system) are all able to help if you need them
The advantage of this method is that it avoids introducing instruments into the cervix or womb. However, even though an early medically induced abortion is often considered to be the best option, it may not be suitable for you

Up to 12 weeks gestation

Early Surgical Termination of Pregnancy

Surgical termination of pregnancy is carried out by suction under a general anaesthetic and undertaken up to 12 weeks of pregnancy. The operation is usually performed within the day unit at the Women's Centre, as a day case and does not involve any kind of cutting.

The treatment involves:

Medical Assessment (as above) NB you will not be admitted the same day
Admission to the day surgery unit at the Women's Centre, John Radcliffe Hospital, a few days after your medical assessment. PLEASE voice any worries or concerns that you may have on arrival. If you are not sure about going ahead with the abortion you must tell the nurse looking after you. Once you have been admitted and all the medical checks have been done it is sometimes necessary to have a prostaglandin tablet put into the vagina. This helps to soften the cervix, and reduces the amount of bleeding that occurs. You may experience some cramp like pains after the vaginal prostaglandin tablets have been inserted
A general anaesthetic is then injected through a fine needle into a vein in the back of your hand or arm. As soon as you are asleep the pregnancy tissue is removed by suction and D&C (dilatation and curettage). The instruments are passed through the cervix into the uterus. The whole procedure takes only a few minutes.
After the anaesthetic has worn off you should be able to leave the hospital after 3-6 hours. Take some sanitary pads with you into hospital and do not use tampons until your next regular period
You may bleed for up to 2 weeks and some women have a slight blood loss until their next period starts. This is quite normal. If a lot of bleeding occurs please see your Doctor as soon as possible as you may need a D&C. The staff on the ward can advise you too Tel: 01865 222001/2
If you have a profuse or offensive vaginal discharge, lasting pain or temperature you need to see your Doctor quickly. Infection can occur after a termination (Antibiotics may have been given you to start on the day of termination)
Do not have sexual intercourse until the bleeding has stopped. And use an effective form of contraceptive. The Medical Centre or Family Planning Service provides a comprehensive range of contraceptives. Contraceptive pills or injections can be given to you while you are in hospital
You will need to have a final check up 2 weeks later with your GP or Family Planning Clinic to check that everything is back to normal
You may feel low for a time after the termination, but as your body returns to normal this should settle. If you feel upset it often helps to talk to someone about it and the Doctors, Practice Nurses, Health Visitors, Tel: 01865 483193 Brookes counsellors Tel: 01865 484650 or the specialist counsellor at the Women's Centre Tel: 01865 221235 (if you have had your termination within the Oxford system) are all able to help if you need them.

Beyond 12 weeks gestation

Prostaglandin termination of pregnancy

For pregnancies that have progressed beyond 12 weeks gestation prostaglandin termination of pregnancy is carried out by making the womb contract like a mini labour to expel the pregnancy tissue. It is performed on level 7, the Women's Centre in the John Radcliffe Hospital.

Treatment involves key stages which may vary so the method that will be used for you will be decided and discussed by the doctors and nurses seeing you at the hospital.

Medical assessment (as above)
A tablet called RU486 also known as Mifepristone or Mifegyne. RU486 (Mifepristone or Mifegyne) is taken two days before the termination itself is performed
Two days later you will be admitted to the Women's Centre, Level 7 and prostaglandin, either pessaries or tablets, are inserted into your vagina. The tablets need inserting on two or more occasions in most patients
An oxytocin drip may be given through a fine needle into a vein in the back of your hand. The effect is to make the uterus contract and induce a mini labour like a miscarriage. The procedure may take up to 24 hours or more. You can have pain killers as you need them
Bleeding will begin as you miscarry and large clots of blood and tissue will come away. Bring sanitary pads with you into hospital
The Nurses and Doctors will make sure that you are progressing and will monitor your care and treatment. You might be able to go home that day but be prepared to stay overnight (Antibiotics may have been given you to start on the day of termination)
You may bleed for up to 2 weeks and some women have a slight blood loss until their next period starts. This is quite normal. If a lot of bleeding occurs please see you Doctor as soon as possible as you may need a D&C. The staff on level 7 can advise you too
If you have a profuse or offensive vaginal discharge, lasting pain or temperature you need to see your Doctor quickly or ask the staff on level 7. Infection can occur after a termination
Do not have sexual intercourse until the bleeding has stopped. And use an effective form of contraceptive. The Medical Centre or Family Planning Service provides a comprehensive range of contraceptives Contraceptive pills or injections can be given to you while you are in hospital
You will need to have a final check up a few weeks later with your GP or Family Planning Clinic to check that everything is back to normal
You may feel low for a time after the termination, but as your body returns to normal this should settle. If you feel upset it often helps to talk to someone about it and the Doctors, Practice Nurses, Health Visitors, Tel: 01865 483193 Brookes counsellors Tel: 01865 484650 or the specialist counsellor at the Women's Centre Tel: 01865 221235 (if you have had your termination at the Women's Centre) are all able to help if you need them

If you are 18 to 24 weeks pregnant you will be referred to specific health care organisations with clinics outside of Oxford. The way terminations are performed may be different from those used in Oxford and will be discussed with you in the event of a referral.

Further details about termination of pregnancy are available from your GP or Family Planning service.