Termination of Pregnancy

ConditionsConditions

There is no condition information for this clinic

For surgical terminations of pregnancy, as well as for women who are assessed by the referrer as unsuitable for Medical Termination of Pregnancy (MTOP) and can be seen at the clinic within an appropriate gestation (see referral process); for follow up of failed medical termination of pregnancy (MTOP); or for medically stable patients with complications of MTOP.

Availability

North South North West Statewide

Scope

Vulnerable women will be prioritised for access.

These gynaecological clinics do not provide initial counselling regarding unplanned pregnancies. See Public Health Services - Termination of Pregnancy website for links to these services.

Surgical Termination of Pregnancy

Surgical terminations of pregnancy, as well as for women who are assessed by the referrer as unsuitable for Medical Termination of Pregnancy (MTOP), and can be seen at the clinic at less than:

  • 12+0 weeks gestation at Mersey Community Hospital
  • 13+0 weeks gestation at Launceston General Hospital
  • 14+0 weeks gestation at Royal Hobart Hospital

If the regional hospital is unable to accommodate a referral, the woman will be contacted by the regional hospital and assisted to receive care elsewhere. There will be no out of pocket expenses for clinical care for women eligible for this service after the referral is received.

Complications of Medical Termination of Pregnancy (MTOP)

There are two infrequent situations for which a prescriber (or other medical practitioner) will need to refer a patient despite good planning/procedures. These may be:

  1. The stable patient where the MTOP has failed and the uterus still contains the foetus. See referral process.
  2. The unwell/unstable patient who may have excessive bleeding, pain or infection. See referral process.

Referral process

Prior to referral the referrer should ensure the woman has had appropriate counselling, including consideration of the option of MTOP.

Referral for surgical termination of pregnancy

A referral with all requested results included is required. All referrals should comply with referral standards and the referrer should:

  • Provide clinical information:
    • LMP
    • relevant past gynaecological, obstetric and medical history
  • Detail the reasons for consideration of prioritisation for vulnerability. For example (not exclusive):
    • victims of assault and/or domestic violence (known or suspected)
    • social or financial disadvantage, including those with a Health Care Card
    • women who identify as Aboriginal or Torres Strait Islander
    • women with acute stress or mental illness or other medical illness
    • women with physical or intellectual disability.
  • Preferably provide at least 2 methods for contacting the patient.

Tests

  • FBE
  • Beta hCG
  • Blood group and antibodies
  • Early pregnancy ultrasound scan for dating
  • STI screen

Referral for complications of MTOP

1) The stable patient where the MTOP has failed and the uterus still contains the foetus:

  • In this situation the prescriber/GP is to refer the patient to the Gynaecology clinic. Phone and fax the clinic coordinator in your region (see Clinic Details) and mark the fax URGENT and clearly stating it is a Failed MTOP.
  • Provide explanation and all appropriate information: scans, medications given, dates, Beta hCG etc., vital signs. The woman will be assessed in clinic and a suitable time for surgery booked in subsequent days.

2) The unwell/unstable patient who may have excessive bleeding, pain or infection:

  • The prescriber/GP is to provide explanation and refer the patient to the Emergency Department for assessment. The gynaecology registrar will be contacted by ED when/as required.
  • Either fax the ED or provide a letter with the appropriate information already to hand: scans, meds given, dates, Beta hCG, vital signs.

Consider referral to clinicians who provide counselling and who provide Medical Terminations of Pregnancy in the community (see Public Health Services - Termination of Pregnancy website and Tasmanian Health Pathways).

Emergency

The unwell/unstable patient who may have excessive bleeding, pain or infection.

Proceed to Emergency Department (ED).
LGH ED Reception – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent / category 1

The stable patient where the MTOP has failed and the uterus still contains the foetus.

Referral template

For use by health professionals only

Additional information

Tasmanian Health Pathways website

Public Health Services - Termination of Pregnancy website