Causes & Treatment

Dilation & curettage – what it is, why you might need one & a recovery plan

Jessie Day  |   2 Oct 2023

What’s a D&C, in simple terms?

A D&C – dilation and curettage – is a medical procedure, used to remove tissue from inside your uterus. In the care of a medical professional, a D&C is very safe and effective. But even the safest, most effective treatment – whatever aspect of health we’re navigating – can come with its own difficulties, trauma and need for a specific recovery plan. 

It’s far too easy, when providing guidance and information, to minimise the experience of a D&C. Yes, it is classed as ‘minor surgery’. And very often used to remove the ‘products of conception’, following a miscarriage. But neither of these terms are satisfactory, because they reduce dilation and curettage, and a pregnancy, to something small and perfunctory. We think. 

So, what is a D&C, really? In this guide we’ll aim to cover: 

  • definitions, and what happens during treatment
  • signs you might need a D&C 
  • recovery thoughts, from rest to nourishment and other aspects of self care

Who might need a D&C?

The likelihood is, you’ll first hear of a D&C when it’s presented as a treatment option by your medical team. Or maybe, if a friend or family member has one. It’s a fairly standard procedure following a ‘missed’ miscarriage (where the baby has died but you haven’t yet physically miscarried), or incomplete miscarriage. 

In the USA, this procedure is frequently referred to as a D&C. In the UK, terminology and procedure can be slightly different – your doctor will often refer to treatment as surgical management, following miscarriage. 

Today, we’re focusing on D&C following miscarriage, but the procedure is commonly used for many reasons, including to: 

  • remove tissue left behind in the uterus after miscarriage
  • remove tissue for analysis
  • remove an intrauterine device (IUD) form of birth control
  • investigate heavy menstrual bleeding, or bleeding between periods
  • remove fibroids 
  • clear infected tissue
  • remove and biopsy any tumours in the uterus 
  • remove tissue left behind following childbirth
  • perform an abortion

You may also have read up on a procedure called a dilation and evacuation (D&E) – this is similar to a D&C but usually done in the second trimester, and involves more surgical work to remove the pregnancy tissue. 

signs you need a d&c

What happens during a D&C procedure?

A D&C will happen in a hospital or surgical treatment centre. It’s usually straightforward for a doctor to perform, with patients able to go home the same day. You can opt to have your D&C under: 

  • a local anaesthetic, and remain awake for the procedure, or 
  • general anaesthetic, and not be awake at all

Your doctor should take the time to discuss all the options with you beforehand, as well as what to expect. Many women describe feeling some cramping under local anaesthetic, so if you’re staying awake, this may be something to prepare for – from wearing loose, comfy clothes to ensuring you have someone to help you, after the D&C is finished. 

You may also be given antibiotics, to help prevent infection. Speak to your doctor about the full treatment route they suggest, and any concerns you have – everything is completely valid, and you should feel entirely heard, and in control of the journey. 

During a D&C, your doctor will: 

  • examine your cervix, assessing whether it’s open
  • if your cervix is closed, they’ll gently dilate it using a specialist instrument, inserted to open the cervix
  • they’ll then place a speculum, to keep your cervix open 
  • remove the necessary tissue from your uterus, either using a curette instrument, or a suction curettage 

A D&C usually takes around 15 to 20 minutes to complete. 

Who might need a D&C, following miscarriage?

Again, your doctor or team may suggest a D&C for other reasons than miscarriage – for example, to remove an IUD (intrauterine device). But following the loss of a pregnancy, D&C might be recommended if: 

  • you’re 10 or more weeks into pregnancy 
  • you’re bleeding heavily and continuously
  • your pregnancy has had complications
  • there’s a risk of infection
  • you have a medical condition which could require emergency care
  • expectant (natural, at-home) or medical management are unsuccessful 

A D&C recovery plan  

You’ll read pretty much all over the place that D&Cs are quick, and that most women are discharged from hospital just a few hours after. This may be the case, but it doesn’t help much with planning for recovery, and caring for your body after the procedure. 

A miscarriage, even at an early stage, is a very physical experience – many of the hormonal shifts women experience post-birth are at play, and you’ll also be working with blood loss, fatigue and possible cramping and soreness. 

Adding a D&C procedure into the journey adds another dynamic to recovery. Here’s what we suggest as focuses, for your D&C recovery. 

1. Know your meds

This will depend on your doctor’s specific guidance, following the D&C and before you’re discharged from hospital. Often they will prescribe an antibiotic, to help prevent infection, and pain medication (usually ibuprofen) for any cramping and discomfort. 

Check everything through with your practitioner, including how long you should take any prescribed meds for. And perhaps most importantly, ensure you have a number to call or contact details, for any concerns about infection or pain after being discharged. 

2. Go gently

The first step – getting home. Don’t try to drive or manage a commute yourself, lean on your support network and ask someone to help. 

Your practitioner will probably advise using pads for any bleeding after a D&C, and we’d definitely steer clear of tampons. Sex is also best avoided until your bleeding has stopped, and so is swimming. 

A warm bath is usually ok three to five days after your procedure, but stick to showers before that – just leave out any perfumed bubble baths and soaps, and go gently. Douching is definitely off the menu. 

how many days rest after d&c

3. Schedule a follow-up

Ideally, this will be done automatically for you by the doctor and their team. If you come away without details for a follow-up appointment, call up and get one booked in, when you’re feeling up to it. 

Follow-ups after a D&C are really important for supporting a full recovery, and answering any question you may have. 

4. Take a probiotic

A D&C is, by nature, an invasive procedure, and can affect our delicate vaginal flora balance. We’d suggest taking a good probiotic during this time and across your recovery – look for one which includes lactobacillus. 

We love this one by Nutri Advanced, which is designed for use after illness, antibiotic use or significant change to our microbiome. TRB readers also get 20% off with the code TRB20 right now too, so do make use of that!

5. Support your immune system

Focus on boosting your immunity after a D&C, to help prevent any post-procedure bacterial or viral infections. Our go-tos right now as we enter immunity season are: 

  • lymphatic support (try the legs up the wall yoga pose once you’re feeling up to it a few days in)
  • green smoothies to pack a nutrient-dense, infection-busting punch (think spinach or chard, full-fat coconut milk, frozen mango, flax seeds and a good protein powder) 
  • cacao for a shot of powerful immunity-boosting properties, easily blended into a hot chocolate, smoothie or sweet treat
  • echinacea as a top preventative, to help guard against infection before it even gets going
  • vitamin A-rich foods (brightly coloured squashes, root veg, bell peppers and greens are some of our favourite sources), packed into a one-pot evening stew or soup, to gently nourish while you recover 

A D&C is no small thing. And regardless of what guidance Google might highlight, the key to good recovery is giving yourself time to heal. Mobilise your support network, talk about it as much (or as little) as you need to, with someone you trust, and know that your body has done the most incredible work, over this time. 

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