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There are few things in life as difficult and soul-crushing as losing a pregnancy. Nothing can prepare you for being told that your baby no longer has a heartbeat, for finding out your dreams aren’t coming true this time around.
In the moments immediately following this type of news, it can be difficult to process the various options presented to you. Should you wait and see if the miscarriage passes on its own, should you go the medicated route, or should you opt for a dilation and curettage procedure (D&C)? In some instances, despite what you decide, if the miscarriage doesn't physically progress on its own, your healthcare provider may recommend a D&C to avoid any further complications.
While it's devastating finding out that you need surgery to remove what's left of a very wanted pregnancy, knowing what to expect can help you feel more prepared during a process that is largely out of your control.
What Is a D&C?
During a D&C, your cervix is dilated so that your doctor can use a curette, or a spoon-shaped tool, to scrape away your uterine lining, removing abnormal tissue. In simpler terms, a D&C is a routine procedure in which the doctor scrapes your uterine walls, removing fetal tissue and any other products of conception. Additionally, a D&C can be performed via suction rather than scraping—a decision that your doctor will make depending on what’s best for you and your health.
D&C can also be used to diagnose and treat other conditions that may affect the uterus, such as abnormal bleeding. In addition, it can be utilized to detect endometrial cancer.
Reasons to Have a D&C After a Miscarriage
The majority of miscarriages occur early on in pregnancy within the first 12 weeks. D&C is typically only used for early miscarriages under a particular set of circumstances: if the tissue remains in the uterus or if no embryo forms in the uterus.
Sometimes, your doctor may discover that the pregnancy is going to miscarry, but it hasn’t started yet. D&C procedures can be used if you don’t want to wait for the miscarriage to start on its own, or if you have a history of complications following a pregnancy loss.
What Happens During a D&C?
Most D&Cs are performed as outpatient procedures either in a hospital or your OB’s office. Depending on the type of anesthesia you and your team decide is best for you, you may need to fast beforehand. Some women may go under light sedation or total general anesthesia, while others may choose to do local anesthesia that just numbs the pelvic area.
During the procedure, you will lie on your back with your feet in stirrups much like the position you assume during a pelvic exam. A speculum will be inserted into your vagina so that the vaginal walls can be spread apart, providing clear access to the cervix. Your healthcare provider will clean your cervix with an antiseptic solution and then dilate it. Next, using the curette, your doctor will scrape the walls of your uterus. Occasionally, your doctor may use suction to remove the tissue in your uterus.
The entire procedure takes roughly 30 minutes.
How Long Is The Recovery From a D&C?
You may experience light bleeding after a D&C procedure. While recovering over the next few days, you may have some cramping and bleeding, which can last for a few weeks. You can take over-the-counter pain relief medications to help with any pain and discomfort.
As always, contact your doctor if the bleeding is heavy, your cramps are severe, or you suspect that you have an infection.
The physical risks and recovery are minimal with a D&C procedure, but that doesn’t mean you can bounce back to your regular activities right away, as the mental and emotional recovery can take much longer. It’s OK to need more time. Take all the time you need to grieve, listen to your body, and seek out counseling if you feel you need it.
You can expect to resume a normal menstrual period within six to eight weeks following a D&C procedure. However, this can depend on how far along the pregnancy was when the miscarriage occurred. Talk to your doctor about how long you should wait before trying to conceive again—that is if you want to! Everyone responds to pregnancy loss differently, and no matter what you decide, your feelings are valid.
Brighid Flynn is a freelance writer based in Philadelphia where she lives with her husband and puppy. She is just beginning her journey toward motherhood.