During a typical D&C, a doctor will first dilate the cervix, which is the narrow, lower part of the uterus. The next step is the removal of tissue from the lining of the uterus, and possibly other material from inside the uterus. Your physician may gently scrape the lining of the uterus with a small, spoon-shaped device called a curette, or they might use a suction device to remove the material instead. We turned to some experts to learn more about the process of having a D&C, the benefits, and what the recovery entails.
Types of D&C
There are two types of D&C that you might encounter: a diagnostic D&C and a therapeutic D&C.
Diagnostic D&C
You may undergo a diagnostic D&C so your doctor can learn more about a symptom you’re experiencing, like abnormal bleeding, which could be the result of fibroids, polyps, hyperplasia (abnormal growth of the uterine lining), or endometrial cancer (cancer of the lining of the uterus). During the procedure, your doctor will obtain some samples from your endometrium, which is the lining of your uterus, for further examination. “All the tissue that is either scraped or suctioned form the uterus is then collected in a container and sent to pathology for evaluation,” says gynecologic surgeon Julia Arnold VanRooyen, MD. Your doctor may also perform a D&C in conjunction with another procedure, like a hysteroscopy, an exam of the uterus that entails threading a lighted, flexible tube through the vagina.
Therapeutic D&C
A therapeutic D&C may be necessary if you have a miscarriage, including situations when the fetal tissue doesn’t pass on its own. “Although many miscarriages happen spontaneously and progress to completion without medical intervention, sometimes pregnancy tissue can be retained in the uterus, and a D&C may be required to complete the process,” says Dr. VanRooyen, adding that patients who have incomplete miscarriages can experience prolonged bleeding and cramping. “A D&C completes the process and decreases the risk of infection.” A D&C can also be performed to terminate a pregnancy. According to Dr. VanRooyen, suction is the most commonly used method for performing first-trimester surgical abortions.
Benefits of a D&C
A D&C can rule out problematic conditions, notes Dr. VanRooyen, but it can also treat or stop abnormal bleeding. For example, if you have a cervical polyp that may be protruding through your cervix, the D&C can remove the tissue and you shouldn’t experience any more bleeding, she says. Plus, the procedure can produce a tissue sample that a pathologist can examine to determine if there are any precancerous or cancerous cells. Additionally, a tissue sample analysis might shed some light on any possible genetic factors that contributed to a miscarriage, notes Shahin Ghadir, MD, an OB/GYN and reproductive endocrinologist with the Southern California Reproductive Center. Another benefit of undergoing a D&C after a miscarriage: it may allow you to move forward. “A miscarriage can be an emotional process,” says Dr. Ghadir. “You may not want to wait one to 10 weeks for it to pass on its own. Some people want it over with as soon as possible.”
How to Prepare for a D&C
Your doctor may perform this procedure in a hospital, a professional office, or an outpatient surgery center. You’ll want to arrange to have enough time to travel to the location where you’ll be undergoing the procedure. Prior to your appointment, your doctor will give you specific instructions about how to prep. For example, your physician may ask you to refrain from eating after midnight the night before. You may also need to abstain from drinking water for a couple of hours prior to your surgery.
What to Expect on the Day of Your D&C
You’ll probably need to arrive about an hour before the scheduled procedure. When you get there, you’ll check in and then change into a medical gown. A member of the healthcare team will insert an IV into your arm. You may also receive some medication to begin the process of dilating your cervix. Then it’s time for anesthesia. Depending on the setting and your medical history, you may opt for general anesthesia, or you can ask for regional or local block anesthesia. Dr. Ghadir says he prefers the outpatient surgery center setting over the doctor’s office because patients can be completely sedated, which often makes the procedure easier for them.
Process of Getting a D&C
During the procedure, your doctor will insert a speculum into your vagina, while your cervix is held in place. Then, using the curet or the suction or vacuum pump, your doctor will gently remove the tissue from the lining of the uterus. In the case of a D&C after a miscarriage, the products of conception will also be removed. Typically, the procedure itself takes about 10-15 minutes, says Dr. VanRooyen. The entire process takes about 15-30 minutes from start to finish. “It’s a very quick procedure,” says Dr. Ghadir. “You don’t feel anything, and it’s done.”
Recovery After a D&C
After your procedure, you should expect to remain in a post-operative recovery area for about one or two hours, says Dr. VanRooyen. Once you go home, you may experience some mild bleeding and/or cramping. A sanitary pad, a heating pad, and a low dose of ibuprofen can help you navigate the next day or two. However, if you have heavier bleeding—that is, if your sanitary pad gets soaked within a couple of hours—you should call your healthcare provider. You may also experience some spotting for a while—perhaps for several weeks, according to Dr. VanRooyen. A new lining will begin to develop in your uterus. “Patients can expect to resume their normal menstrual cycles anywhere for two to six weeks after a D&C,” she says.
Complications After a D&C
Possible complications of a D&C can include uterine perforation, infections, and scar tissue formation. If scar tissue fills the uterine cavity, it can potentially prevent menstruation and your ability to conceive; this is a condition called Asherman’s syndrome. However, while complications can occur, they are pretty rare. A D&C is generally considered a safe procedure. “If done under the right hands and by someone who is knowledgeable, it should not harm your uterus,” says Dr. Ghadir. And barring any other complications, a D&C should not hamper your ability to conceive in the future. However, you may want to wait at least four weeks to give your uterus some time to heal first. If you have any concerns during your recovery, be sure to reach out to your OB/GYN or healthcare provider.
A Word From Verywell
If your OB/GYN or healthcare provider suggests that you consider a D&C, rest assured that this is a fairly common procedure. That said, it’s normal to have questions about what the procedure entails, what to expect before and after, and what sort of complications to look out for during recovery. Your healthcare provider can explain more about how the procedure may benefit you, as well as any possible risks you may want to consider.
