NHS Devon CCG intends to procure Termination of Pregnancy Services within the community for the population of Devon.
The service will provide:
— counselling and assessment,
— offer a choice of medical or surgical ToP before 24+0 weeks gestation,
— contraception,
— completion of forms required under the Abortion Act,
— follow up (if clinically indicated or required by service user),
— provide consultations by phone or video call for women who prefer it. Settings of services to include hospital and in the community.
The service will provide:
— counselling and assessment,
— offer a choice of medical or surgical ToP before 24+0 weeks gestation,
— contraception, providers should ensure the full range of reversible contraceptive options is available for women on the same day as the ToP, with staff who have the knowledge and skills to provide these, including implants and intrauterine devices if this is what the woman chooses. For women having medical ToP and who choose depot medroxyprogesterone acetate as contraception provide this at the same appointment they take mifepristone, explain that there is a risk of ongoing pregnancy, but this is low,
— completion of forms required under the abortion act,
— follow up (if clinically indicated or required by service user),
— services should be sensitive to the service user’s needs and feelings. Information, both written and verbal, should be provided in an objective and non-judgmental way, which allows service users to make choices. Inform that ToP does not increase risk of long-term health problems. Provide information about benefits and risks of medical and surgical methods of termination without being directive, so that women can make their own choice. The guideline provides detailed information on these, differentiating risks and benefits for each by gestational stage. Provide detailed information as early as possible to help women prepare- to include what it involves, what happens next, pain and bleeding to expect. Use a variety of formats. If the ToP method is medical include what they may see, what it will look like whether there may be any movement. If the ToP is at home include how to be sure the pregnancy has passed. Provide information on signs and symptoms to indicate they may need medical help after a ToP and who to contact. Provide information about different ways of handling foetal remains. If ToP is for foetal anomaly and this is not in a maternity setting, have clear referral pathways and communication routes to enable easy transfer and enable the woman to get more information about the anomaly,
— provide consultations by phone or video call for women who prefer it. Settings of services to include hospital and in the community.