What to Expect From a D&C for Early Miscarriage

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In This Article

A D&C, or dilation and curettage, is a routine surgical procedure performed on women 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.

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, and may also be used to detect endometrial cancer.

Overview

A D&C is not always medically necessary following a miscarriage. If a woman has unusually heavy bleeding as a miscarriage complication, a D&C can stop the bleeding .

Benefits

A D&C may make it easier to collect a usable tissue sample for couples who want to pursue chromosomal testing on the fetus .

Risks

A D&C is considered safe, but there are some risks of complications such as puncturing the uterus, weakening the cervix (increasing the risk of later cervical insufficiency), and scarring the uterus .

The risk of reaction to anesthesia is small, however, it may be a serious complication. If you have had a prior reaction to anesthesia, be sure to tell your doctor.

Personal Preferences

50% 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 without the procedure. A miscarriage is complete when the uterus has emptied out the embryo or the contents pertaining to 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

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 and 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.

Contact a doctor if you have heavy bleeding or severe cramping, or if you have symptoms of infection following a D&C.

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 again, your doctor may advise waiting for one to two menstrual cycles to begin trying to get pregnant again. But depending on how far along you were when you had your miscarriage, some doctors may advise waiting longer in some cases, while others may say you can start trying again right after your next period.

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Article Sources
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  1. The American College of Obstetricians and Gynecologists. Dilation and Curettage. Updated March 2019.

  2. American Cancer Society. Tests for Endometrial Cancer. Updated March 27, 2019.

  3. The American Society for Reproductive Medicine. Abnormal Uterine Bleeding. (2012)

  4. D'ippolito S, Di Simone N, Orteschi D, et al. The chromosome analysis of the miscarriage tissue. Miscarried embryo/fetal crown rump length (CRL) measurement: A practical usePLoS One. 2017;12(6):e0178113. Published 2017 Jun 12. doi:10.1371/journal.pone.0178113

  5. American Pregnancy Association. D&C Procedure After a Miscarriage. Updated October 11, 2019.

  6. American Pregnancy Association. Miscarriage: Signs, Symptoms, Treatment, and Prevention. Updated October 10, 2019.

  7. American Pregnancy Association. D&C Procedure After A Miscarriage. Updated October 11, 2019.

  8. Schliep KC, Mitchell EM, Mumford SL, et al. Trying to Conceive After an Early Pregnancy Loss: An Assessment on How Long Couples Should WaitObstet Gynecol. 2016;127(2):204–212. doi:10.1097/AOG.0000000000001159

Additional Reading
  • American Pregnancy Association. D&C Procedure After Miscarriage. Updated October 11, 2019.

  • John Hopkins Medicine. Dilation and Curettage (D&C).

  • The American College of Obstetricians and Gynecologists. Induced Abortion. Updated May 2015.