We are a midwife-led outpatient service for early pregnancy problems up to 12–13 weeks. We’re here to support you during this stressful time.
If you are experiencing any of the following, you should go to the Emergency Department for assessment first (they will refer you to Early Pregnancy Service if indicated):
- Shock or collapse
- Severe pain
- Heavy bleeding (soaking sanitary towels 1-2 hourly) or passing large clots
- Shoulder tip pain
- Rectal pressure
- Bowel or urinary problems
Appointments
Unfortunately, we do not offer a walk-in service or dating scans for the British Pregnancy Advisory Service (BPAS).
Referrals are made by GPs, Emergency Department, 111, midwives, private scan services and BPAS (should concerns that meet our criteria arise after assessment/BPAS scan/treatment).
We also accept self-referrals.
Once a referral has been made, the Early Pregnancy Service midwife will speak with you over the phone to assess your symptoms (within one working day) and will develop a plan of care with you. Not everyone will need to be seen.
It is important to get in touch with us if you have had any of the following:
- a positive pregnancy test and have a coil fitted
- a positive pregnancy test and have been sterilised
- had a previous ectopic pregnancy
- had a previous molar pregnancy
- recurrent miscarriage (3 or more)
- Health conditions where you are seeing a specialist or taking medication for such as (cardiac issues, high blood pressure, clotting issues, epilepsy, antipsychotic medication or mood stabilisers) or multiple medication
- Past history of DVT or clotting disorder and/or pregnancy sickness
Routine investigations
Patients are seen by a nurse or doctor and an ultrasound may be performed. The scan will be performed vaginally in order to accurately visualise the pregnancy to help with the diagnosis. This technique is not harmful to you or your pregnancy.
Sometimes in early pregnancy, it can take time to work out what is happening because pregnancies are so small at this stage. It may mean they can't be seen on a scan, requiring follow up blood tests to monitor your pregnancy hormone levels (HCG).
We understand that procedures like vaginal scans or blood tests can feel scary, especially if you’ve experienced trauma or have a needle phobia.
We appreciate that this can be a very stressful time and we are here to support you. Whilst you are under our care, please feel free to contact us. There is no such thing as a silly question.
What to expect
We offer expectant, medical and surgical management of miscarriage. This means that if a miscarriage is diagnosed, you will be given the option of waiting to see if the pregnancy tissue passes naturally, or taking tablets to speed up the process, or a small operation to empty the womb. There are a few exceptions to this and you will advised and supported throughout.
We also offer expectant management for the treatment of ectopic pregnancy. Some ectopic pregnancies will resolve on their own with close observation and regular follow up. Some ectopic pregnancies can be treated with a drug called Methotrexate and others require an operation.
Most of the operations for ectopic pregnancy are carried out by keyhole surgery which means an admission to hospital.
We aim to provide a supportive, flexible service, please let us know how we can help you feel safe, such as offering extra time, a different waiting area or other adjustments.
You can find support services listed in the useful links section.
