Abortion

The Lothian Abortion Referral Service (LARS) is based at Chalmers Centre. LARS operates Monday to Friday from 9am-3pm, excluding public holidays.

For their initial assessment, patients are offered consultations at the Choices Clinic in the Chalmers Centre, or at St John’s Hospital (for West Lothian based patients). Most of these initial consultations are telephone/ telemedicine. Under 16s and other vulnerable groups are prioritised for an in-person consultation.

Abortion Care delivery in Lothian.

Ultrasound assessment will be arranged where a woman is: uncertain of her last menstrual period, or has symptoms or history to suggest an ectopic pregnancy, or is 12 or more weeks pregnant, or requests to have a scan.

The procedure chosen will depend on the gestation as measured by scan when the patient is first seen:

Early Medical Abortion at Home (as an outpatient) for those up to 12 weeks can be delivered from both Chalmers Centre and St John’s Hospital
Women choosing a surgical abortion up to 12 weeks will undergo this procedure at the Royal Infirmary of Edinburgh or St John’s Hospital
Women requiring hospital admission for a medical abortion will undergo this procedure at the Royal Infirmary of Edinburgh or St John’s Hospital.

Self – referral for abortion.

Women across Lothian can self-refer for abortion (direct telephone call to Lothian Abortion Referral Service (LARS); telephone 0131 536 1070 (Mon- Fri 9-3 pm)). LARS staff will give women an appointment for a telemedicine/ telephone assessment with a clinician based at Chalmers or St Johns Hospital, or an in person consultation where indicated.

Telemedicine/ telephone assessment.

The content of the consultation (including decision, future contraception) and documentation is the same as an in-person consultation, but consents are verbal. Doctors in the abortion service prescribe and sign Certificate A (legal requirement).

Women who fulfil the criteria of the 1967 Abortion Act, certain of their decision, less than 12 weeks gestation and eligible for medical abortion can have an early medical abortion at home (EMAH). Women with significant medical conditions or unsuitable for home treatment will have the procedure in hospital, as will women > 12 weeks gestation (Royal Infirmary of Edinburgh or St John’s Hospital). Surgical abortion is also available up to 12 weeks for those choosing that option.

Early Medical Abortion at Home.

Medication packs are made up at Chalmers and St John’s Hospital. The packs contain medical abortion medication (mifepristone and misoprostol), as well as anti-emetics, analgesia, a postal test for chlamydia / gonorrhoea if wished, a pregnancy test to confirm the success of the procedure and information including emergency contact numbers and numbers for ongoing advice/support. A patient information leaflet on EMAH is available.

Who to refer:

GPs should refer patients who have decided to proceed with an abortion. If the woman requires further counselling, she will be referred by the service (see below).

If further advice is required, please contact Choices nursing staff at Chalmers Sexual Health Centre on 07765395887.

Advice about a termination for fetal anomaly or advice about possible risk of anomaly from teratogen exposure during pregnancy can be obtained from the feto-maternal team on 0131 242 2546. Please note that this is for use by professionals only.

Post-abortion support:

Post abortion counselling support provided is from Chalmers: further details are outlined on the ‘After care advice and support’ leaflet and patients can self-refer. Women identified as requiring pre-abortion counselling will be referred from the abortion clinic.

Who not to refer:

Women with suspected ectopic pregnancy or miscarriage should be discussed with Pregnancy Support Centre on 0131 242 2425/2438.

Later gestation referrals (18 weeks+) should also be discussed by telephone with Choices nursing staff at Chalmers Sexual Health Centre on 07765395887 (or 0131 536 2105) in the first instance.

How to refer:

There are three ways of referring patients to the service:

1. Self-referral
Patients wishing to self-refer need to call:
0131 536 2454 between the hours of 9am to 3pm Monday to Friday.
Patients will be asked for some personal details (address, phone number, LMP, date of positive pregnancy test etc) relating to the appointment. Patients will have their first appointment at the Chalmers Centre, or St John’s Hospital if they live in West Lothian.

2. GP referral

GPs can also refer women using SCI Gateway:

Chalmers Sexual Health Centre > Gynaecology Abortion referrals
St John’s Hospital (West Lothian patients) > Gynaecology Abortion referrals

Please choose St John’s Hospital for referrals to West Lothian and NOT the RIE.

The Certificate A can be scanned and attached to the SCI gateway referral, but this is not a requirement.

The GP practice will be notified of the appointment by 4.30pm Monday – Thursday and by 4pm on Friday. Practices should make arrangements for contacting the patient with their appointment details.

3. Referral from another clinic within NHS Lothian (e.g. a young person or sexual health clinic)

Young people can attend a healthy respect plus clinic (which includes a walk-in facility), and anyone can pre-book appointments at either the Chalmers Centre or local clinics to discuss a request for abortion with a health care professional. Following this they would then be referred to the Choices Clinic at the Chalmers Centre or to St John’s Hospital, if they live in West Lothian.

PLEASE NOTE:

Very urgent referrals should be discussed by telephone with Choices nursing staff on 07765 395887. Please ensure that the department is informed of any special requirements, such as need for interpreters, or unsuitable dates for attendance due to other commitments.

ALSO:

Patients who are having an ultrasound should attend the appointment with a full bladder.

Patients should be advised to read the patient information leaflet on Lothian Sexual Health Website Abortion page and watch the short animations regarding a visit to the clinic.

All patients who agree to mobile contact will also receive a text message to inform / remind them of their appointment. For GP referrals we ask the surgery to contact women – but if a mobile number is provided – then the patient will ALSO get a text reminder. The text message will read as follows:

Reminder for your appointment at on xx-xx-xxxx. Please phone 0131 536 2105 if you wish to reschedule

or
Confirmation of your face to face appointment on xx-xx-xxxx. To reschedule please phone 0131 536 2105. Please Attend with a Full Bladder.

Further Contacts

You may discuss patients by calling LARS (Lothian Abortion Referral Service) on 0131 536 2105 (answer phone) or email us

Patient Information Leaflets

http://www.lothiansexualhealth.scot.nhs.uk/

Lothian Abortion Referral Service(LARS)Chalmers Sexual Health Centre
2a Chalmers Street
Edinburgh
EH2 9ES

0131 536 2105

Pregnancy Support Centre

Tel: 0131 242 2425 / 2438

Feto-maternal team
Antenatal outpatient services
Simpson Centre for Reproductive Health,
Royal Infirmary Edinburgh,
51 Little France Crescent,
Edinburgh EH16 4SA

Tel: 0131 242 2546

St John’s Hospital
Howden Road
Howden
Livingston
West Lothian
EH54 6PP
Ward 12 – 01506 524 112
Gynae Outpatients Department – 01506 554 383

UK Teratology information service (A national service on all aspects of toxicity of drugs in pregnancy)