Generally speaking, a D&C is a routine procedure that healthcare providers use to help your body heal and return to its pre-pregnancy state. Below, we walk you through what a D&C is, what to expect, and how long your recovery will take.
D and C Procedure for Miscarriage
A dilation and curettage (or D&C) is a routine surgical procedure performed following a miscarriage during the first trimester or to diagnose and/or treat conditions that affect the uterus such as abnormal bleeding. It can involve the use of a spoon-shaped device called a curette which gently scrapes the lining of the uterine wall. Or, suction may be used instead. A D&C is similar to suction curettage, the procedure used to induce an abortion up to the first 12 to 13 weeks of pregnancy. It may also be used to detect endometrial cancer. A D&C is not always medically necessary following a miscarriage. If a woman has unusually heavy bleeding as a miscarriage complication, however, a D&C can stop the bleeding.
Benefits and Risks
After a miscarriage, a D&C may make it easier to collect a usable tissue sample for couples who want to pursue chromosomal testing on the fetus. Some women choose a D&C so they do not have an emotionally difficult wait to miscarry naturally in the case of a missed miscarriage. A D&C is considered safe, but there are some risks of complications. These may include puncturing of the uterus, weakening of the cervix (increasing the risk of later cervical insufficiency), and scarring of the uterus. Half of women who have a miscarriage do not require a D&C procedure. A D&C is performed to confirm that a miscarriage is complete, though a completed miscarriage can also be verified by an ultrasound. A miscarriage is complete when the uterus has emptied out the embryo or the products of conception. The primary function of a D&C is to ensure that all fetal tissue is expelled from the uterus to prevent hemorrhaging as well as infection. Most doctors will respect the woman’s wishes in cases where natural miscarriage does not pose an immediate risk to the woman’s health.
Preparing for a D&C
A D&C can be performed either in a hospital or a doctor’s office. When scheduling the procedure, you will be given instructions to follow. You may be asked to avoid eating and drinking for a period of time before your appointment. If your D&C takes place in a hospital, you will have to check in. You will usually undergo a few routine presurgical tests before going to the surgical area.
What to Expect
The experience of a D&C depends on the type of anesthesia. With local anesthesia, the physical procedure may simply seem like a longer pelvic exam. A speculum is inserted into the vagina, local anesthesia is given, and the cervix is dilated. You may experience moderate to severe cramping during the procedure. Many women prefer to have a D&C under general anesthesia or local anesthesia with sedation. If this is the case, you may simply wake up in a recovery area afterward without any memory of the procedure.
Recovery
Physical recovery following a D&C should be relatively swift. Most women can go back to work after a day or two. Your doctor can prescribe pain medication as needed for recovery. You may have vaginal bleeding and cramping for a few days, but it should not be severe or heavy. Your doctor will probably advise avoiding tampons and sexual intercourse for one to two weeks. Most women will resume a normal menstrual period within six to eight weeks after a D&C, depending on how far along the pregnancy was when the miscarriage happened. For couples hoping to try to conceive again, your doctor may advise waiting for one to two menstrual cycles to begin trying to get pregnant again, but not necessarily.
