Female Health

Cervical screening is a method of preventing cervical cancer by detecting abnormal cells in the cervix (lower part of the womb). Cervical screening is not a test for cancer, but it is a test to check the health of the cervix.

Most women’s test results show that everything is normal. But for one in 20 women, the test will show some changes in the cells of the cervix. Most of these changes will not lead to cervical cancer and the cells will go back to normal on their own. In some cases, the abnormal cells need to be treated to prevent them becoming a problem later.

Please let us know if you would like any additional support during your cervical screening by either:

• Filling in our Cervical Screening Additional Support online form.

or

• Print off a paper copy of the Cervical Screening Additional Support form and hand it into the Surgery

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NHS – Cervical Screening – The why, when & how guide to cervical screening

Your guide to NHS cervical screening – GOV.UK including what happens at the appointment, practical hints and support and cervical screening results

NHS – Cervical Screening Easy Read Leaflet

Cervical Screening: Going for a cervical screening test for patients with learning disabilities

Cervical Screening – British Sign Language (BSL) signed content: Taking part in NHS cervical screening

Cervical Screening – Your guide to NHS cervical Screening leaflet sent to all women invited for NHS cervical screening in multiple languages

Well Aware – Women’s Health

Since September 2008 there has been a national programme to vaccinate girls aged 12-13 against human papilloma virus (HPV). There is also a three-year catch up campaign that will offer the HPV vaccine (also known as the cervical cancer jab) to 13-18 year old girls.

The programme is delivered largely through secondary schools, and consists of three injections that are given over a six-month period. In the UK, more than 1.4 million doses have been given since the vaccination programme started.

What is Human papilloma virus (HPV)?

Human papilloma virus (HPV) is the name of a family of viruses that affect the skin and the moist membranes that line your body, such as those in your cervix, anus, mouth and throat. These membranes are called the mucosa.

There are more than 100 different types of HPV viruses, with about 40 types affecting the genital area. These are classed as high risk and low risk.

How you get HPV?

Types of HPV that affect the skin can be passed on by skin contact with an affected person. The types of HPV that affect the mouth and throat can be passed on through kissing. Genital HPV is usually spread through intimate, skin to skin, contact during sex. You can have the genital HPV virus for years and not have any sign of it.

How HPV can cause cervical cancer?

Most HPV infections are harmless or cause genital warts, however some types can cause cervical cancer. Most HPV infections clear up by themselves, but in some people the infection can last a long time. HPV infects the cells of the surface of the cervix where it can stay for many years without you knowing.

The HPV virus can damage these cells leading to changes in their appearance. Over time, these changes can develop into cervical cancer. The purpose of cervical screening (testing) is to detect these changes, which, if picked up early enough, can be treated to prevent cancer happening. If they are left untreated, cancer can develop and may lead to serious illness and death.

Cancer Research UK
HPV Facts and information

NHS – HPV Vaccination Why, how and when is the vaccination given and what are the side effects.

Breast cancer is the most common cancer in the UK. About 46,000 women get breast cancer in the UK each year. Most of them (8 out of 10) are over 50, but younger women, and in rare cases men, can also get breast cancer.

The NHS Breast Screening Programme invites over 2 million women for screening every year, and detects over 14,000 cancers. Dr Emma Pennery of Breast Cancer Care says: “Breast X-rays, called mammograms, can detect tumours at a very early stage, before you’d feel a lump. The earlier it’s treated, the higher the survival rate.”

Find out more about breast cancer screening.

Macmillan Cancer Research
The causes and symptoms of breast cancer in women and explains how it is diagnosed and treated

NHS
Symptoms, diagnosis, treatment, prevention & screening information

Well Aware – Breast Symptoms

All GPs are happy to discuss your contraceptive needs and provide information on the various methods.

Contraception is free for most people in the UK. With 15 methods to choose from, you’ll find one that suits you.

Contraceptive methods allow you to choose when and if you want to have a baby, but they don’t protect you from sexually transmitted infections (STIs). Condoms help to protect against STIs and pregnancy, so whatever other method of contraception you’re using to prevent pregnancy, use condoms as well to protect your and your partner’s health.

Where to get it

Contraceptive services are free and confidential, including to people under 16 as long as they are mature enough to understand the information and decisions involved. There are strict guidelines to for care professionals who work with people under 16.

You can get contraception free from:

• most GP surgeries (talk to your GP or practice nurse),
• community contraceptive clinics,
• some genitourinary medicine (GUM) clinics,
• sexual health clinics (these offer contraceptive and STI testing services), and
• some young people’s services (call 0800 567123).

Find sexual health services

Many of these places also offer information, testing and treatment for STIs. If you’ve been exposed to the risk of pregnancy, you’re also at risk of catching an STI.

Before you make an appointment, make sure you’re as informed as possible about the contraceptive options available. People’s choice of contraception may vary over time, depending on their lifestyle and circumstances.

Contraception and menopause

Women who have sex with men and don’t want to get pregnant need to keep on using contraception until they haven’t had a period for more than 12 months (menopause).

This is because periods can become irregular before they stop entirely, and pregnancy can still occur during this time.

Find out more about menopause

The methods of contraception

There are lots of methods to choose from, so don’t be put off if the first thing you use isn’t quite right for you; you can try another. You can read about each of the different methods of contraception by visiting these pages:

• Combined pill
• Progestogen-only pill
• IUD (intrauterine device, or copper coil)
• IUS (intrauterine system or hormonal coil)
• Contraceptive implant
• Contraceptive injection
• Contraceptive patch
• Vaginal ring
• Condoms
• Internal (female) condoms
• Female sterilisation
• Vasectomy (male sterilisation)
• Diaphragm or cap
• Natural family planning

You can find out more about each type of contraception by contacting:

• CASH on 0300 303 8565.
• Brook Advisory Service (for under-21s) on 0800 988 2209.

In addition to your chosen method of contraception, you need to use condoms to prevent STIs. Always buy condoms that have the CE mark on the packet. This means that they’ve been tested to the high European safety standards. Condoms that don’t have the CE mark won’t meet these standards, so don’t use them.

You can also visit the Family Planning Association website for information.

Well Aware – Contraception

To support the advice you have discussed with the nurse, we recommend visiting some helpful websites:

Tommy’s Charity offers detailed information on preparing for pregnancy – Planning a pregnancy | Tommy’s.

You can find useful guidance on contraception and fertility at Contraception Choices.

Or NHS information on trying for a baby at www.nhs.uk/pregnancy/trying-for-a-baby/.

By signposting these resources, healthcare providers enable women to access further advice in their own time, empowering them to take control of their preconception health.

Your team of Midwives and Midwifery Support Workers (MSW) are:

• Tracey-Morse – Midwife
• Amy Tooms – Midwife
• Siobhan Sayers – Midwife
• Maria Beasley-Suffolk – Midwife
• Gaynor Milkins – Midwifery Support Worker (MSW)
• The Stockwood Health Centre GPs share maternity care with the midwifery team

The midwives and MSWs are all based at South Bristol Community Hospital so if you need to speak to them please contact them on 0117 3429841. They have an answering machine so please feel free to leave your name and a message and for non-urgent calls they will reply within 48 hours. Of course if your call is more urgent they will respond the same day or you can contact your GP for advice.

They run antenatal clinics on a Wednesday morning however they are flexible and will make appointments to suit you should this time be inconvenient.

They also offer ‘Preparation for Parenthood’ classes which are currently held in Burnbush Children’s centre. They discuss all aspects of labour, how your birth partner can support you; when to recognise labour and when to go to hospital; pain relief and what is available to you; the postnatal period and bringing your baby home. They hope to answer any questions you may have so you feel more prepared for your birth experience.

They like to see you for your first appointment before you are 10 weeks pregnant so please contact them when you find out you are pregnant and they can plan ahead and arrange your ‘booking appointment’ and your dating scan appointment.

How to book your first appointment

To make your first appointment with a midwife please complete the online booking form, or call the Antenatal Booking Team on 0117 342 0850.

Explore the midwifery led unit and wards with the virtual tour on St Michael’s website.

Antenatal Classes

You are invited to attend the antenatal sessions where the midwife team will discuss:

• How to recognise labour and what to expect;
• Pain relief for labour and how to help yourself;
• Your partner’s role to support you in labour;
• The postnatal period and what to expect;
• Feeding your new baby;
• And anything else you would like to know.

Self Referral – Women’s Health Physiotherapy

There are also Physiotherapy antenatal classes held throughout the Community and your Midwife can give you details of these.

It is possible to self refer to the pelvic health physiotherapist who will see women from 12 weeks gestation to 6 months post delivery. They are able to give advice on pelvic floor symptoms, including incontinence and pain.

Tiredness and Sickness

Tiredness and sickness are common in early pregnancy, try to eat little and often and drink plenty of water. 

• If you feel tired, listen to your body and rest when necessary. 
• Nausea and sickness usually subside after the first 12 – 16 weeks. 
• It is important to take folic acid as soon as you find out that you are pregnant, this helps with healthy development and growth. 

To access further information on eating, drinking and keeping well in pregnancy go to NHS at www.nhs.uk.

When you have delivered your baby and come home they will visit you to offer you and your family guidance, support and advice about caring for yourself and your new baby; feeding your baby; how you feel about your birth experience and how you feel in general.

If you require further information on pregnancy and childbirth please visit NCT.

Early Pregnancy Assessment Clinics at local hospitals

The Early Pregnancy Assessment Clinic (EPAC) is an emergency clinic for women with suspected miscarriage or ectopic pregnancy.

Southmead, St Michael’s and Weston General hospitals have opened a patient self-referral option making it easier and faster for people requiring early pregnancy services to book an appointment and remove the need to visit a GP, emergency department or other healthcare provider to initiate contact.

The criteria for self-referral are:

1. six weeks – 19 weeks and six days of pregnancy
2. and experiencing bleeding and/or pain
3. or previous ectopic pregnancy
4. or previous molar pregnancy

More information or to access the EPAC self-referral service is available here.

You will find more useful information at Women’s Health – Well Aware including thinking about having a baby, pregnancy options pregnancy problems or loss

Please see below for details of useful websites and apps in the post natal period.

Advice for when your child is unwell:
HANDi app – NHS BNSSG ICB

Breast Feeding Support
Breast Feeding in Bristol

Crying baby advice:
ICON Cope

General advice:
Healthier Together
Women’s Health – Well Aware

Safe sleeping advice:
The Lullaby Trust
Reduce the risk of sudden infant death syndrome (SIDS) – NHS

Pelvic floor exercises:
Squeezy (squeezyapp.com)
Pelvic Floor and Problems with Wee Leaking – Well Aware

Postnatal mental health advice:
Perinatal and postnatal mental health – Mind 
Postnatal depression – NHS (www.nhs.uk)

Vitamins advice:
Vitamins for children – NHS

Self referral – Women’s Health Physiotherapy:
It is possible to self refer to the pelvic health physiotherapist who will see women from 12 weeks gestation to 6 months post delivery. They are able to give advice on pelvic floor symptoms, including incontinence and pain.
My joint health

Prior to your appointment we ask that you complete a Menopause questionnaire. This can help us better understand the extent of your symptoms and can be helpful for monitoring if treatment is working.

Please print and complete the questionnaire, and bring this to your appointment.

You may wish to read more about menopause and HRT before your visit. Reading about the different types of HRT can help us find the best one for you. Below are a variety of sources of information