A D&C (dilation and curettage) is a short surgical procedure where a doctor opens the cervix and removes tissue from the lining of the uterus. The whole thing typically takes 10 to 15 minutes, is done in an outpatient setting, and most people go home the same day. Here’s what happens at each stage.
Why a D&C Is Done
The most common reasons are managing a miscarriage, investigating unexplained uterine bleeding, and removing tissue left behind after childbirth. In miscarriage cases, a D&C clears remaining pregnancy tissue to prevent infection and heavy bleeding. For diagnostic purposes, the removed tissue gets sent to a lab so a pathologist can look for abnormal cells, polyps, or other conditions explaining the bleeding.
Preparing Beforehand
If you’re having general anesthesia, you’ll need to fast for several hours before the procedure, usually starting the night before. In some cases, your doctor may give you a medication to soften and begin opening the cervix ahead of time. This can be taken by mouth or placed near the cervix hours before the procedure, and it makes the dilation step easier and faster.
You’ll also arrange for someone to drive you home, since the effects of anesthesia take time to fully wear off.
Anesthesia Options
A D&C can be done under general anesthesia (where you’re fully asleep), sedation combined with a local numbing injection to the cervix, or regional anesthesia like a spinal block. The choice depends on the reason for the procedure, where it’s being performed, and your preference. Most hospital-based D&Cs use general anesthesia, while office-based procedures may use lighter sedation.
The Procedure Step by Step
You lie on your back on an exam table with your feet in stirrups, similar to a pelvic exam. Once the anesthesia has taken effect, the doctor begins.
Step 1: Exposing the cervix. A speculum is inserted into the vagina to hold the walls apart, just like during a Pap smear. This gives the doctor a clear view of the cervix.
Step 2: Stabilizing the cervix. A gripping instrument called a tenaculum may be placed on the cervix to hold it steady during the rest of the procedure.
Step 3: Measuring the uterus. A thin, rod-like instrument called a uterine sound is sometimes passed through the cervical opening to measure the depth of the uterus. This tells the doctor how far they can safely insert tools in the next steps.
Step 4: Dilating the cervix. A series of thin, tapered rods are inserted into the cervical opening one at a time, each slightly thicker than the last. This gradually stretches the cervix open enough to allow instruments into the uterus. If a cervical-softening medication was used beforehand, fewer rods may be needed.
Step 5: Removing the tissue. Once the cervix is dilated, the doctor removes the dilation rods and inserts a curette, a long, thin instrument with a spoon-shaped edge. The curette is advanced through the cervical canal into the uterus, then drawn along the uterine walls in a systematic pattern, rotating a full 360 degrees to cover the entire inner surface. This scrapes away the uterine lining. In some cases, a suction device is used instead of (or alongside) the curette to vacuum out tissue.
Step 6: Completion. The instruments are removed, and the collected tissue is placed in a specimen container to be sent to a pathology lab. Results typically come back within one to two weeks.
Suction vs. Sharp Curette
The traditional approach uses a metal curette with a sharp, spoon-shaped edge that physically scrapes the lining. The alternative is suction curettage, which uses vacuum pressure (either manual or electric) to draw tissue out. Suction curettage is the standard in pregnancy-related D&Cs and is increasingly used for diagnostic cases too. A study comparing both methods found that suction produced tissue samples with significantly more intact, organized structure, which can make it easier for pathologists to reach an accurate diagnosis.
What Recovery Looks Like
After the procedure, you’ll spend time in a recovery area while the anesthesia wears off, usually about one to two hours. Mild cramping similar to period cramps is normal and can last a day or two. Light bleeding or spotting may continue for up to two weeks.
Most people return to their regular activities within a few days, and many feel back to normal within five days or fewer. You’ll typically be told to avoid sex for about a week and to skip tampons during that time as well, using pads instead. This gives the cervix time to close fully and reduces infection risk.
Risks and Complications
A D&C is considered a safe, low-risk procedure. The most common complication is heavier-than-expected bleeding. Uterine perforation, where an instrument pokes through the uterine wall, occurs in roughly 0.8 to 6.4 out of every 1,000 procedures. The risk is slightly higher for postmenopausal women (about 2.6%) compared to premenopausal women (about 0.3%). Most perforations are small and heal on their own without surgery.
Infection is uncommon but possible. Signs to watch for include fever, worsening pain beyond the first couple of days, or foul-smelling discharge.
Scar Tissue Formation
One longer-term risk worth knowing about is the formation of adhesions, bands of scar tissue inside the uterus sometimes called Asherman syndrome. A meta-analysis published in Human Reproduction Update found that roughly 18.5% of women who had a D&C after miscarriage developed some degree of intrauterine adhesions. Many of these cases are mild and cause no symptoms, but more significant scarring can affect menstrual flow or future fertility. This risk is one reason doctors increasingly favor suction curettage or medication-based miscarriage management when appropriate.
What Happens With the Tissue Sample
The tissue removed during a D&C is preserved and sent to a pathology lab, where it’s examined under a microscope. Pathologists look for signs of abnormal cell growth, hormonal imbalances affecting the uterine lining, polyps, or (in pregnancy-related cases) confirmation that all pregnancy tissue has been removed. Your doctor will contact you with results, usually within one to two weeks, and discuss any follow-up steps based on what the lab finds.