Enlightenment about pregnancy aborts

Fachliche Informationen auf Englisch über Schwangerschaftsabbrüche – zur Verfügung gestellt von einer Frauenarztpraxis

Information about what to do following the procedure:
1.) You should rest. If needed, we will issue a medical certificate confirming your incapacity to work.
2.) Pregnancy symptoms, i.e. nausea and breast tenderness mostly disappear within a few days.
3.) A pregnancy test may still show a positive result for up to 3 weeks after termination of pregnancy
4.) Bleeding might occur, but can be very different from spotting to period like bleeding –
it is normal for the first 10 days but may last up to 3 weeks or until the next normal period comes
on. It should gradually become weaker.
5.) Abdominal cramps are normal, it indicates that the uterus is contracting well.
Moderate exercise is helpful in this process.
6.) Your body temperature may rise up to 38°.

All this is normal!

If you need a painkiller you can buy Ibuprofen 400 or Paracetamol 500 over the counter at a pharmacy. Please do not take aspirin since this medicine may reinforce bleeding.
In all other respects, you can pursue your normal daily activities at a lighter pace. You can take a shower – but please refrain from bathing the first 3 days.
Use sanitary towels for 3 days. After that you may also use tampons again which should be changed minimum every 3 to 4 hours.

You may engage in sexual activities, if you’re feeling well enough. But please be aware that you may get pregnant again as early as 10 days after the procedure. Therefore discuss your wishes regarding further family planning with us.

Please come and see us in the following situations:
o persistent bleeding which is much stronger than your menstrual bleeding
o persistent strong abdominal pain
o persistent temperature of 38° or above

If you are feeling well and have no complaints, make sure to book a follow up at our clinic 10 to 14 days after the procedure.
If you want to use contraceptives (like birth control pills, contraceptive injections, contraceptive patches, vaginal ring):
you should start within the first three days after the termination of pregnancy.
The first monthly bleeding (if not using hormonal contraceptives) is to be expected about four to six weeks after the procedure. It may be stronger and longer than your regular menstruation. If the first monthly bleeding does not stop after 8 days, please come and see us.

Please inform us of any problems that arise which may be related to the termination of pregnancy, as this is the only way for us to review and improve our quality standards.

Thank you very much for the confidence you have placed in us!

Your medical team „Frauenärztinnen Köpenick“
Stand: Juni 2018

Aufklärung Medikamente beim SSA Mifegyne® and Cytotec®.

You have opted for a medical termination of pregnancy with the medicines Mifegyne® and Cytotec®.

This paper will explain the procedure to you.

o You will take Mifegyne® at our clinic
o To increase the effectiveness of this method, you have to take Cytotec® within the following 36 to 48 hours which can be done at your home.
o Bleeding might occur at any stage after you have taken the very first tablet usually this first bleeding is only light.

As you are planning to perform the second part of the termination of pregnancy at home, you should read the following information carefully:
Once you start taking the tablets at home: ensure that an adult person is present! Please have a light breakfast and make sure to drink at least 2 liters during the day.

“HOME USE” – the procedure at Date: ………………………….. Hour: ……………………………:
1.) Please swallow:
1 tablet of Ibuprofen 800,
1 tablet of Buscopan plus® and
1 tablet of Vomacur® or …………………………..
2.) Wait about 30 minutes, then continue with …..……… tablets of Cytotec®.
Place the tablets into the pouches of your cheeks and swallow them after 15-20 minutes.
3.) Bleeding mostly starts after 1-3 hours, it may be very strong and contain tissue parts.
Bleeding will ease after a couple of hours. Make sure you have enough sanitary towels at home.
4.) If bleeding has not started after three hours, then take another 2 tablets of Cytotec® (see above)
5.) In cases of strong nausea or vomiting, take one suppository of Vomacur®
or ………………………….. to be inserted into the anus (anally).
The effect will start after approximately 30 minutes.

6.) To ease the abdominal pain, you may
• put a hot water bottle / warm cherry-pit-pillow on your belly
• rest, relax or move (you know best what will do you good)
• take another tablet of Ibuprofen800 and Buscopan plus®
• In case of severe pain insert one suppository of Titretta® or/and ……………………………………. anally.

If you have any questions about the procedure or in case of very strong bleeding which equals 4 soaked sanitary towels per hour for more than two hours, call the emergency number of our clinic 0176 98 26 96 96 (during our clinic hours) or …………………………………………….
(if you do not get us directly, please leave a message and we call you back ASAP.)
o Please book an appointment with our clinic approximately 10 days after the procedure. This is to perform an ultrasound scan to ensure that the procedure has been successful. A pregnancy may continue despite severe bleeding!
o I have read and fully understood the information about the procedure. My questions have been answered completely. I have no further questions.
o I have received the above mentioned medication. Any pills I will not use will be given back to the clinic.
o I assure that I am not aware of any allergies to any of them.
o I have understood that a follow-up appointment is crucial. I assure that I will attend this follow-up.

Juni 2018

Einverständniserklärung zur Anwendung von Mifegyne® und Cytotec® für einen medikamentösen Schwangerschaftsabbruch

Consent form regarding the application of MIFEGYNE® and CYTOTEC® for medical abortion

Dr. ……………….. has instructed me in a personal consultation about the following points:

• taking Mifegyne® must be followed by the use of a prostaglandin called Cytotec®
• Cytotec® increases the effectiveness of Mifegyne®
• after taking Mifegyne® and / or Cytotec®, side-effects such as headache, nausea, vomiting, diarrhoea, stomach ache, vaginal bleeding and circulary problems may occur
• this method (medical termination) is not 100% effective. However, a surgical procedure (D&C) is only necessary in a few cases (1-3 in a 100).
• Mifegyne® and / or Cytotec® must not be taken in the case of a known hypersensitivity to their effective ingredients
• I understand, that if, after taking Mifegyne® /Cytotec®, I decide to carry the pregnancy to term; this is against medical advice: fetal damage and health risk for the fetus cannot be ruled out.

In Germany, Cytotec® is licensed for the prevention and treatment of gastritis / duodenal and stomach ulcers. It is not licensed for the termination of pregnancy, but is allowed within the medical freedom of therapy to prescribe and apply Cytotec® – this is a so called off label use.

Cytotec® has been used in gynaecology and obstetrics for more than 30 years. The World Health Organisation (WHO) recommends the combination of Mifegyne® /Cytotec® for medical abortion. This is in particular due to its high effectiveness, low rate of side effects and good tolerance.

o A medical follow-up after the application of Mifegyne® / Cytotec® is absolutely necessary.
o I have fully understood the information given, my questions have been answered
o I have no further questions.
o I wish the medical termination of pregnancy to be performed using Mifegyne® / Cytotec®.

Mifegyne No.: …………………………………………….

Juni 2018

What is chlamydia?
Chlamydia is a common sexually transmitted disease (STD) caused by a bacterium.

How do people get chlamydia?
People get chlamydia by having sex with someone who has the infection. “Having sex” means anal, vaginal, or oral sex. Chlamydia can still be transmitted even if a man does not ejaculate. People who have had chlamydia and have been treated can get infected again if they have sex with an infected person. Chlamydia can also be spread from an infected woman to her baby during childbirth.

Who is at risk for chlamydia?
Any sexually active person can be infected with chlamydia. It is a very common STD, especially among young people. Sexually active people are at high risk of acquiring chlamydia for a combination of behavioral and biological reasons.

What are the symptoms/complications of chlamydia?
Chlamydia is known as a ‘silent’ infection because most infected people have no symptoms. If symptoms do occur, they may not appear until several weeks after exposure. Even when it causes no symptoms, chlamydia can damage a woman’s reproductive organs.

In women, the bacteria first infect the cervix (structure that connects the vagina or birth canal to the uterus or womb) and/or the urethra (urine canal). Some infected women have an abnormal vaginal discharge or a burning sensation when urinating. Untreated infections can spread upward to the uterus and fallopian tubes (tubes that carry fertilized eggs from the ovaries to the uterus), causing pelvic inflammatory disease (PID). PID can be silent, or can cause symptoms such as abdominal and pelvic pain. Even if PID causes no symptoms initially, it can lead to infertility (not being able to get pregnant) and other complications later on.

How does chlamydia affect a pregnant woman and her baby?
In pregnant women, untreated chlamydia has been associated with pre-term delivery, and can spread to the newborn, causing an eye infection or pneumonia. Screening and treatment of chlamydia during pregnancy is the best way to prevent these complications. All pregnant women should be screened for chlamydia at their first prenatal visit.

Who should be tested for chlamydia?
Chlamydia testing is recommended and paid by the German insurance for all women age 25 or younger and all pregnant women. Any woman who is sexually active should discuss her risk factors with a health care provider who can then determine if more frequent testing is necessary.

How is chlamydia diagnosed?
There are laboratory tests to diagnose chlamydia. Specimens commonly used for testing include a urine sample. Please collect the first urine in the morning and bring it to us the same day till 12 am.

What is the treatment for chlamydia?
Chlamydia can be easily treated and cured with antibiotics. Persons with chlamydia should abstain from having sex for seven days after single dose antibiotics, or until completion of a longer course of antibiotics, to prevent spreading the infection to partners.

Repeat infection with chlamydia is common. Persons whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a woman’s risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated.

What about partners?
If a person has been diagnosed and treated for chlamydia, he or she should tell all anal, vaginal, or oral sex partners from the past 2 months so that they can be treated. This will reduce the risk that the sex partners will develop serious complications from chlamydia and will also reduce the person’s risk of becoming re-infected.

How can chlamydia be prevented?
Latex male condoms, when used consistently and correctly, can reduce the risk of getting or giving chlamydia. The surest way to avoid chlamydia is to abstain from vaginal, anal, and oral sex or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.