Termination of Pregnancy
Adult

Gynaecology

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Emergency Referrals

Useful Management Information

In an emergency situation, medical and clinical staff cannot conscientiously object to providing care
following a failed early medical termination. All Hospital and Health Services will provide services to
women who present for emergency care.
A Registered medical practitioner may perform a lawful termination on a woman who is:
- up to a gestational limit of 22+0 weeks, for any reason
- 22+1 weeks of gestation or more if two medical practitioners agree that, in all the circumstances, the
  termination should be performed.
Termination of pregnancy is a time sensitive service and that delays impact on the woman or pregnant
persons options.
- An early medical termination that can normally happen at home and is available under the
  supervision of a GP up to 9 weeks (63 days) gestation
- From 9 weeks gestation the woman or pregnant person will need to be admitted to hospital to have a
  termination
Legal requirements if a medical practitioner conscientiously objects to provide termination of pregnancy
services.
- The Termination of Pregnancy Act 2018 recognises that registered health practitioners have, and
  may exercise, the right to freedom of thought, conscience and religion. There is a requirement in the
  Act for a registered healthcare practitioners to inform the woman of their conscientious objection
  status and refer the woman in a timely manner to alternate, accessible and willing registered
  healthcare practitioners who can provide the required service.
  Routine termination of pregnancy is not available at Gold Coast Health.
Local Hospital and Health Services provide a limited number of appointments for terminations. Priority
appointments for terminations will be given to women with complex health care needs and no ability to
have a termination in the private sector where most terminations are performed.
Statewide Termination of pregnancy clinical guidelines states under the Clinical Standards that:
- Ideally, offer an assessment appointment within 5 days of referral
- Ideally provide termination within 2 weeks of the decision to proceed being agreed
Offer referral to other services as appropriate, especially where risk factors are identified (e.g. young women, women with physical or intellectual disabilities, mental illness, rape or sexual assault, domestic violence, fertility issues and cultural beliefs/values).
Where a young woman is sixteen years of age or under, greater consideration of an independent and appropriate counsellor/support person being available and engaged should be considered.
Consider primary health screening or advice. i.e. Cervical Screening, Sexual Health Check, Rubella titre, domestic and family violence or sexual violence, smoking cessation advice.
Counsel about pregnancy options and contraceptive advice.
Consider providing advice that in an emergency situation, medical and clinical staff cannot conscientiously object to providing care following a failed early medical termination. All Hospital and Health Services will provide services to women who present for emergency care.

Clinical resources

Clinical Excellence Queensland information for health practitioners and services: Termination of Pregnancy
Queensland Clinical Guideline: Termination of Pregnancy

Patient resources

13 HEALTH (13 43 25 84) is a phone line that provides health information, referral and services to the public
Children by Choice
1800 177 725 (free call) offers free all-options pregnancy counselling, information and referrals Queensland-wide.
Women’s Health Queensland
1800 017 676 (free call) offers health promotion, information and education services for women and health professionals throughout Queensland
True Relationships and Reproductive Health  provides expert reproductive and sexual health care.
Key facts about Termination of Pregnancy Act

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Any patient requesting a termination of pregnancy. For optimum care, an assessment appointment should be offered within 5 days of referral. NB: Full termination of pregnancy services may not be offered by individual hospitals. Referral may well be accompanied by a telephone call to the local Hospital and Health Service to establish local guidelines. This could include discussion with the responsible clinician or delegate. Request for termination service 22+1 weeks have additional complexities and should be discussed with the responsible clinician.
Category 2 (appointment within 90 calendar days)	No category 2 criteria
Category 3 (appointment within 365 calendar days)	No category 3 criteria
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Summary of relevant circumstances leading to the request for termination of pregnancy
Medical, surgical, obstetric and psychosocial history
Menstrual history and last menstrual period (LMP) date (if available)
Confirm the diagnosis and gestation of intra-uterine live pregnancy by ultrasound*

*Where access is limited in regional/rural centres consider referral prior to ultrasound

Additional Referral Information

BMI
Blood group and type
Routine antenatal bloods: FBC, rubella antibody, hepatitis B serology, hepatitis C serology, HIV serology, syphilis serology
HPV vaccination history
STI screen result – endocervical swab or low vaginal SELF SWAB. Also screen for chlamydia +/- gonorrhoea NAA, T vaginalis, M genitalium (highly desirable)
STI screen might not be available before referral but is an essential part of the management.
History of smoking and alcohol and drug use
If pregnancy >11 weeks, Down syndrome screening results – screen at 11 to 14 weeks: fetal ultrasound + serum βhCG + serum PAPP-A (results required if completed, not necessary if thinking of Termination of Pregnancy)

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Health Service District

Internal Referrals

Gynaecology (E-Blueslips)
Colposcopy (E-Blueslips)

Fax

(07) 5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Graeme Walker

Medical Director Gynaecology

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Termination of PregnancyAdult