What Happens in During a Dilation and Curettage(D&C)?

A D&C is one of the most common surgical procedures performed on women. A D&C is a generally performed to diagnose a condition. Having a D&C performed gives women more information and treatment options. Many years ago, when a woman was suffering with uterine conditions, the most common treatment was a hysterectomy or removing the uterus.

A D&C is also performed frequently after a woman has a miscarriage. Many times after a pregnancy loss, the uterus does not completely empty. This puts a woman in danger of severe infection and future infertility. Regardless of the reason for needing a D&C, the procedure is the same. If you’ve been told that you need a D&C, gathering information before and understanding the procedure is a great way to prepare.

What a D&C is:

A D&C or dilation and curettage is a minor surgery. Most D&C’s, unless they are performed as an emergency procedure, can be performed in a doctor’s office using local anesthetic. If a doctor’s office is not possible, a D&C can be performed in a hospital.

Depending on your individual circumstances, you may or may not be given antibiotics to help prevent infection. Most women are asked to refrain from food or drink for several hours before the procedure is to be performed. This is the case with most surgical procedures

The D&C Procedure:

Women should expect to be positioned as if they were having a pelvic exam, on the back lying with legs in stirrups. After the woman has been made comfortable with anesthetics, the vagina is then cleansed with an antibacterial agent. If a woman is having a D&C under general anesthesia, she will not be awake during the procedure.

A doctor will insert a speculum into the vagina to hold it open so that the cervix can be dilated. The cervix will need to be dilated so that instruments can be placed within the uterus to scrape the lining. There are several methods that can be used to dilate the cervix. The more common method involves inserting small rods into the cervix. These rods are called metal dilators. If a woman is under local anesthetic and therefore awake, she may experience some “cramping” sensations as the cervix begins dilating.

The curettage portion of the D&C can now be performed. A long instrument called a curette will be placed into the uterus through the dilated cervix. The curette has a metal loop at the end of it. The doctor will gently begin to scrape away the uterine lining until all uterine contents are removed. The total time the procedure lasts varies, but generally the procedure can be completed in less than 30 minutes.

D&C Aftercare:

After the D&C procedure, it is normal to experience light bleeding and cramping. Women are instructed to refrain from sexual activity. Women are also instructed to refrain from inserting anything into the vagina for at least 2 weeks after the procedure. Keep in mind that each doctor is different and will have their own unique post procedure instructions that need to be followed. Depending on the reason for the D&C, a doctor may have sent some uterine tissue to a lab to be analyzed. If this is the case for you, you will need to follow up with your doctor to check your results.

Although the D&C procedure is classified as a minor surgery, it does come with risks:

• Uterine perforation (puncture)

• Infection

• Blood Loss

There is some research that indicates that the D&C procedure can cause a weakened uterus. That may or may not affect future pregnancies. There is not enough evidence available to prove or disprove this idea. Every woman experiences and recovers from a D&C in a different way. If you are instructed to have a D&C, you should follow your doctor’s advice and instructions in regards to things to do before and after the procedure.