London: Difference between revisions

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'''OVERVIEW'''  

As one of the largest cities in Europe, you'll find an incredible range of health care resources in London. Even better, many of these services are accessible to the public and free of charge, supported by the National Health Service (NHS). Many sexual health services run separately from the NHS and do not require any visa checks. In the United Kingdom, contraception is legal and diverse in choices, but remember that a prescription is required for all but emergency contraception. To obtain emergency contraception (the morning after pill), it's recommended to visit a special clinic for EC if you're under 16. You can find ellaOne, the longest-lasting EC, in the United Kingdom. For STI testing and support, there are many free and anonymous facilities in London. If you are interested in a public testing facilities, Better2Know is recommended. For menstrual needs, you'll be able to find common products, like pads and tampons, as well as less commonly used products, like menstrual cups, at select UK sellers. Maternity leave is covered for women under certain conditions for up to 52 weeks. Finally, abortion is generally legal, but there are certain restrictions and requirements that should be observed.

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here].  

In the United Kingdom, a prescription is required to obtain birth control. Overall, contraceptive use is very common with an estimated 84% of women of reproductive age using some form of contraception and 22% of women using oral contraceptives.<ref>[http://www.infoplease.com/ipa/A0193123.html Prevalence of Contraceptive Use in Selected Countries]</ref> Furthermore, it's estimated that the United Kingdom has the second most prevalent usage of condoms in the world.<ref>[https://www.google.com/maps/d/u/0/viewer?mid=1CHn6J3MIZbMD2fHhX-gt3n9wOA4&hl=en_US Most Prevalent Condom Use Around the World]</ref>

Contraceptive services are available free on the NHS. Most GP surgeries can prescribe contraception.  More information is available on the NHS choices contraception guide.[http://www.nhs.uk/Conditions/contraception-guide/Pages/where-can-i-get-contraception.aspx].

* Tip for travelers: "If you tell a UK doctor you're going away for 12 months they will usually give you enough to last until you're back on British soil." - Female traveler

[[File:Cerelle unitedkingdom.jpg|300px | thumb|left|frame|'''Cerelle birth control from the United Kingdom''']]

* [https://www.brook.org.uk/ Brook]: "Brook has services across the UK offering free and confidential sexual health advice and contraception to young people under 25. Appointments are not usually necessary as we work on a drop in basis." Drop in services are frequently only available to younger people. For other services, an appointment is necessary. If you go into a GP in the area you live in, they can give you a list of the clinics in the area to call for appointment availability.  

London is also home to a number of sexual health clinics, many of which offer walk-in appointments, and provide services free-of-charge to people of all ages. A complete list is available through NHS choices.[http://www.nhs.uk/service-search/Sexual-health-services/London/Results/609/-0.085/51.511/1847/13136?distance=25]

In addition, many GP surgeries provide sexual health services and offer same-day appointments, though in some areas there may be a wait to get an appointment for a prescription for birth control, and more than one appointment may be necessary to get long lasting contraception such as IUDs, which are largely handled by doctors. Nurses can place the implant and handle patient intake. Waits of more than a month are not uncommon in certain areas, such as London. However, you can call daily to get an appointment slot at an earlier time, as there are frequently cancellations.

* [https://www.theonlineclinic.co.uk/ The Online Clinic] : The Online Clinic is one of the most established online healthcare providers, founded in 2004 to provide online consultations and treatments using a remote doctor/patient interface, and one of only a handful licensed by the Care Quality Commission.  

The Online Clinic are great for providing repeat prescriptions on contraceptives.

The contraceptive pill on prescription is free on the NHS. Most other forms of contraception are also free of cost on the NHS - just ask your GP. You need to be registered with a GP and have a UK address to get prescriptions, although pharmacists will be able to advise on emergency contraception.  

Sexual health clinics usually give away free condoms.

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

EC is available OTC to women over 16 in the UK without a prescription. EC may also be prescribed, dispensed by GPs, or available at sexual health clinics.

'''Note:''' The longest-lasting EC is currently [http://www.ellaone.com/ ellaOne]. It lasts up to 5 days (120 hours) after unprotected sex. Check to see if your country carries ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

The NHS recommends IUDs, which are only placed at clinics, as EC.  

In the United Kingdom, you can obtain oral EC without a prescription.  

Here's what you can get:<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref>

''Dedicated Products / Anti-Progestin

Take 1 pill within 120 hours after unprotected sex:''

* ellaOne (link to [http://www.ellaone.co.uk/ UK website])

''Dedicated Products / Progestin Only

Take 1 pill within 120 hours after unprotected sex:''

* Levonelle-2 (available from a pharmacist without a prescription)

''Oral Contraceptives used for EC / Progestin Only

Take 40 pills within 120 hours after unprotected sex:''

* Neogest

''Take 50 pills within 120 hours after unprotected sex:''

* Microval

* Norgeston

''Oral Contraceptives used for EC / Progestin-Estrogen Combined

Note: in 28-day packs, only the first 21 pills can be used

* Ovranette

EC is free through the NHS, or can be purchased at many pharmacies for about £25.

LNG: € 6,97, as of 2013; UPA: € 19,75, as of 2013.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/united-kingdom/ EC Status and Availability: United Kingdom]</ref>

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

In August 2016, the High Court ruled that the NHS is responsible for funding PrEP. However, as reported by AIDSMap: "NHS England said today in response that the High Court ruling does not mean the medication will end up being funded by the NHS, and warned today that manufacturer Gilead Sciences now faces a blindfold bidding war with other pharmaceutical companies to make its product affordable enough to be prioritised by NHS England for funding."<ref>[http://www.aidsmap.com/High-Court-rules-NHS-England-is-responsible-for-funding-PrEP/page/3076337/ High Court rules NHS England is responsible for funding PrEP]</ref> For now, a small amount has been given for NHS funding, while a legal battle is ongoing regarding which level of government, the national or local (counsil) level is responsible for PrEP.

Here's a [http://www.nhs.uk/service-search/Sexual-health-information-and-support/London/Results/161/-0.085/51.511/734/13136?distance=25 comprehensive list of testing facilities in London], provided by NHS.

* [https://www.better2know.co.uk/ Better2Know UK]: "The UK's Largest Private HIV, STI & STD Testing Provider. Fast STI & HIV Test Results. Nationwide Clinics or Test At Home. See Your Private Nurse at Any of Our Nurse Stations. 100% Confidential & Completely Anonymous."

*[http://www.thesticlinic.com/ The STI Clinic] : "The UK's Largest Independant Online Sexual Health Service. They offer the widest range of tests, tailored to your needs. Simply order the test kit online, provide your sample and access results online. Treatment is included."

* Metro Sexual Health clinic Queens Park http://www.mshatqueenspark.org.uk/

* [http://herpes.org.uk/ Herpes Viruses Associations UK]

* [http://www.nhs.uk/conditions/Hepatitis-C/Pages/Introduction.aspx NHS Choices: Hepatitis C]

* [http://www.nhivna.org.uk/ National HIV Nurses' Association]

Nurses give Gardasil vaccinations to girls as part of standard childhood immunizations. Vaccinations are given free to women on the NHS up until age 18.

Private clinics also given Gardasil, though there have been nationwide shortages preventing adults from receiving the immunization at many clinics.

If obtained through the NHS, Gardasil is free. If you get it through a private clinic, it could cost around 400 GBP for the whole course.

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

In the United Kingdom, you can find pads, pantyliners, tampons and menstrual cups. For basic menstrual needs, you should be able to find them at most drug stores, like Boots or Superdrug. For DivaCup, check out [http://www.femininewear.co.uk/ Feminine Wear UK], [http://www.moontimes.co.uk/ Moontimes], [http://www.TheRawGreek.com The Raw Greek] or [http://www.StressNoMore.co.uk Stress No More]. For Mooncup, check out [http://www.earthwisegirls.co.uk/ Earthwise Girls]. For natural, reusable menstrual products, check out [http://www.honouryourflow.co.uk/ Honour Your Flow].

If you are going through the NHS, your GP intake will include a standard PAP smear, STI testing, and a physical check on an IUD placement. You will have to go to the GP, register, then make an appointment for a later day, where you bring a urine sample and then do a standardized patient intake followed by a PAP smear.

For trans and non-binary individuals, you can get a free cervical smear test at [https://cliniq.org.uk/www-cliniq-org-uk/sexual-health-clinical-services/ Cliniq]. They also provide contraception, confidential HIV tests and other services.

Gynocological exams handled by nurses at GPs through the NHS are free.

In the United Kingdom, you're eligible for maternity leave is you're an employee, not a "worker." You must earn earn on average at least £112 a week and, until the "qualifying week," you must have worked for your employer for 26 weeks continuously. Note that the "qualifying week" means the 15th week before the expected week of childbirth. You must have proof of pregnancy. You must also give your employer proper notice [https://www.gov.uk/maternity-pay-leave/how-to-claim according to protocol.]  

Regarding time, statutory maternity is leave is for 52 weeks in the United Kingdom. This includes ordinary maternity leave (first 26 weeks) and additional maternity leave (last 26 weeks). According to the law, you are not required to take off 52 weeks. But you must take off at least 2 weeks after your baby is born (or four weeks, if you work in a factory). You can typically begin your maternity leave 11 weeks before your due date (at the very earliest). You must give your employer at least 8 weeks' notice if you wish to change your return date.  

In terms of payment, you receive 90% of your weekly earnings (before taxes) for the first 6 weeks. For the next 33 weeks, you receive £139.58 or 90% of your average weekly earnings (whichever is lower). Check out this [https://www.gov.uk/pay-leave-for-parents Maternity Pay Calculator] to see what you may get.

You can still get maternity leave if your baby is born early, is stillborn (after the start of the 24th week of pregnancy) or dies after birth.

For more information, check out the [https://www.gov.uk/maternity-pay-leave UK Maternity Pay & Leave website].

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

In the United Kingdom, with the exception of Northern Ireland, abortion is permitted during the first 24 weeks of gestation. Women are allowed to obtain abortions for the following reasons: to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, fetal impairment or economic/social reasons. Abortion is not available on request in the UK.  

To obtain an abortion, spousal consent is not required. But medical consent is required. Two registered medical practitioners (or, in an emergency, only one) need to certify that the abortion is required on medical grounds, as stipulated in the Abortion Act 1967. The abortion must be performed in a National Health Service (NHS) hospital or in an NHS-approved place, which may be a private hospital, nursing home or another facility.  

When a woman is up to nine weeks pregnant, medical abortions can be performed with Mifepristone (abortion pill). From the seventh to fifteenth week, the suction/vacuum aspiration is most commonly performed. From the fifteenth to eighteenth week, surgical dilation and evacuation methods are most commonly performed. It is estimated that 30% of abortions in the United Kingdom are medical rather than surgical.<ref>[https://en.wikipedia.org/wiki/Abortion_in_the_United_Kingdom Abortion in the United Kingdom]</ref>

Abortion in the United Kingdom is protected under the Abortion Act of 1967, which was amended by the Human Fertilization and Embryology Act of 1990. The Act applies to England, Wales and Scotland. It does not apply to Northern Ireland. According to the Act, "a person shall not be guilty of an offence under the law relating to abortion when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith"<ref>[Abortion Act 1967]</ref> that the pregnant woman falls under criteria for permitted abortions.

In 1991, the UK became the second country, after France, to approve the use of RU-486 (the abortion pill). The pill is currently controlled by the National Health Service, which distributes it to gynecological units in the UK. In 2011, the BPAS attempted to force the Health Secretary to allow women to administer second dosages of medical abortion treatments at home. This was lost in High Court.

Generally, Great Britain is pro-choice. In 2004, a poll found that 75% of Britons believe abortion should be legal.<ref>[https://en.wikipedia.org/wiki/Abortion_in_the_United_Kingdom Abortion in the United Kingdom]</ref>

Personal accounts of obtaining an abortion in the UK:

* [https://www.theguardian.com/lifeandstyle/2006/oct/27/healthandwellbeing.society The Guardian: Nine women share their personal stories of abortion]

* [http://www.stylist.co.uk/life/abortion-unheard-stories Abortion: The unheard stories]

* [http://www.healthcentre.org.uk/abortion/find.html NHS Abortion Services]: You may be eligible for a free abortion through NHS at various hospitals. Check out this link to find an NHS service near you.  

* [https://www.bpas.org/ British Pregnancy Advisory Service (BPAS)]: "British Pregnancy Advisory Service was established as a registered charity in 1968 to provide a safe, legal abortion service.... Today we provide services on behalf of the NHS across the country from Cornwall to Scotland and in Wales also. Today over 95% of the women we take care of have their treatment paid for by the NHS."

* London Central Day Surgery Unit: bpas, 26-27 Bedford Square, London, WC1B 3HP, Tel: 08457 30 40 30

According to UKHealthCentre: "Having an abortion with the NHS should not cost you anything but this very much depends on the local NHS Trust in your area.  Sometimes the NHS will pay for you to have an abortion at a private clinic. Private clinics charge different prices.  These costs can depend on the number of weeks you are pregnant and prices range from £400 - £800.  It is often cheaper and quicker to have an abortion earlier in your pregnancy."<ref>[http://www.healthcentre.org.uk/abortion/find.html UK Abortion Clinics]</ref>

In the UK, counseling is unregulated. However, there are licensing organizations such as the BACP (British Association for Counslling and Psychotherapy) and UKCP (United Kingdom for Counseling and Psychotherapy). Depending on the circumstances, the NHS may cover counseling, but queues for counseling services can vary widely by region and practitioner.

* [https://www.relate.org.uk/ Relate]: The UK's largest counseling service for relationship support, sexual issues, etc. You must be 18+ to contact them for sexual issues.

* [http://www.lifecentre.uk.com/ LifeCentre]: "We are here to support survivors of rape and sexual abuse and their supporters. We trust this web site will be a positive start to giving you the hope and information you may need. Our services are for women and men, girls and boys of all ages and backgrounds."

* [http://www.rasasc.org.uk/ Rape and Sexual Abuse Support Centre]: National Freephone Helpline: 0808 802 9999, 12:00 – 14:30 daily, 19:00 – 21:30 daily. "Rape Crisis South London run the Rape Crisis National Helpline for female survivors of sexual violence. The Helpline is accessible 365 days a year to women aged 14 + who have survived any form of sexual violence, no matter how long ago. We offer specialised, confidential support, information and referral details completely free of charge." Also offers counseling, advocacy, outreach.

* In England, for medical advice contact NHS: Dial 111

* NHS’s Worth Talking About helpline: 0300 123 29 30, Mon-Fri, 2pm-8pm Sat-Sun 2pm-4pm.

* [http://www.beaumontsociety.org.uk/ The Beaumont Society]: "We are the largest and longest established transgender support group in the UK, and have developed a support network which has been at the forefront of the transgender, transvestite, transsexual and cross-dressing community since 1966!"

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