Dilation and curettage

A dilation and curettage (D&C) is used to treat an early pregnancy that has stopped growing, or remove tissue that did not come out after a miscarriage. A gynecologist does the D&C in an operating room under a general anesthetic.

About the procedure

During a D&C, the gynecologist will open your cervix (dilation) and remove the pregnancy tissue (curettage). This may be performed by suction (vacuum-like instrument) and/or by gently scraping the uterine wall with a curette instrument.
A D&C is a day procedure, meaning you go home the same day. You may need an urgent D&C if you have very heavy bleeding.

Risks

Complications are rare with D&C. Possible risks include:

infection (less than three per cent)
trauma to the uterus or cervix (puncturing the uterus, weakening the cervix or scarring in the uterus)
a small amount of tissue may stay inside the uterus
risks associated with anesthesia, such as a reaction to medication or breathing problems

Getting ready for a D&C

A D&C is a scheduled procedure and is usually arranged within one or two weeks. It is a day procedure, meaning you can go home the same day.

You will need to discuss your appointment with the early pregnancy loss team. They will review your medical history, help you get ready for the procedure and explain what to expect during your recovery.

You are welcome to bring a support person with you during your pre-admission appointment and on the day of your D&C.

What to expect after a D&C

Most patients recover quickly from the procedure and will go home within a few hours. You will need a friend or family member to drive you home and have a responsible adult stay with you overnight.

Cramping

You may have some strong cramping at first, but this should not last longer than 24 hours. Mild cramping may come and go for up to one week.

You can take medication for your pain such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol). It is important to follow the recommended amount listed on the package. You may alternate between ibuprofen and acetaminophen.

Bleeding

You may have some bleeding. For the first two to three days it may be as heavy as a period or may only be light to moderate. You may pass a few blood clots as large as a loonie (coin).

After one week the bleeding should be light. It is normal to have spotting for up to 2 weeks.

While you are bleeding:

use pads instead of tampons
shower instead of having a bath
do not use hot tubs or swimming pools
do not have sexual intercourse until your bleeding has completely stopped for 2 weeks

Activities

Most women return to normal activities within a few days after a D&C. You can help your body recover by:

drinking extra water to stay hydrated
eating healthy meals
avoiding vigorous exercise until your bleeding has completely stopped for 2 weeks. After two weeks of no bleeding you can increase your activities.

Your next period

You can expect to have a menstrual period in six eight weeks after your miscarriage.

Contraception

Use contraception to prevent pregnancy until after your first period following the miscarriage. Wait one menstrual cycle before trying to get pregnant again. Talk to your primary healthcare provider about this at your follow-up appointment.

Tender breasts

It is normal to have tender breasts, and this should go away in a few days.

You may also see fluid leaking from your breasts. Wear a well-fitted bra that is not tight and put a cotton pad inside, if needed.

Tiredness

It is important to get plenty of rest.

Make sure you eat healthy foods, drink lots of water and continue your prenatal vitamins until the bottle is finished.

You can go back to work, school and driving as soon as you feel ready. Our team can give you a note for time off work if you need one.

Coping with losss

There are a wide range of feelings you may have after your pregnancy stops growing. You may feel fear, relief, guilt, anger, shock or even numbness. All feelings are normal and okay to have, and your partner’s feelings may be very different from your own.

Often, no reason for a miscarriage can be found. Give yourself time to feel sad, cry and talk about your feelings and what happened. It is hard to know how long it will take for you to feel better, but it may help to:

talk to someone who will listen and understand
be kind to yourself. Do not expect too much of yourself and try to be with people who are caring
get in touch with a support group or talk with other people who have experienced a miscarriage

When to get help

Emergency department

Go to the nearest emergency department if you:

have chest pain
have shortnes of breath
cough up blood
have very heavy vaginal bleeding (soaking through four large pads in two hours)
have dizziness that does not go away with rest or causes you to faint

Primary healthcare provider

See a primary healthcare provider, such as a family doctor, if you:

have signs of infection, such as:
- new, increasing, or foul-smelling vaginal discharge
- fever over 38oC or chills
feel sick to your stomach or cannot drink fluids
have pain that does not get better after you take pain medication
cannot pass gas or have a bowel movement
have symptoms of a blood clot in your leg such as:
- pain in your calf, back of the knee or groin
- redness and swelling in your leg
have bleeding and cramping for more than two weeks

Follow-up care

The early pregnancy loss program nurses will continue to monitor your healing and provide emotional support after your D&C.

We encourage you to have a follow-up appointment with the gynecologist who performed your D&C, or with your primary healthcare provider, six weeks after the procedure.