A D&C (dilation and curettage) is a surgery, but it’s classified as a minor surgical procedure. It’s typically done on an outpatient basis, meaning you go home the same day. A gynecologist or obstetrician performs it in a doctor’s office, hospital, or surgical center, and the procedure itself usually takes only 15 to 30 minutes.
Why It’s Considered Surgery
A D&C involves physically opening the cervix (the dilation part) and using a surgical instrument to scrape or suction tissue from the lining of the uterus (the curettage part). Because it’s an invasive procedure that requires anesthesia and carries surgical risks like infection or bleeding, it meets the medical definition of surgery even though it’s relatively quick and straightforward.
The setting can range from a doctor’s office to an operating room, depending on why you’re having it done. A D&C performed purely to collect a small tissue sample for diagnosis may happen in an office. When the goal is to remove a larger amount of tissue, such as after a miscarriage, it’s more commonly performed in a hospital or surgical center.
Common Reasons for a D&C
D&Cs fall into two broad categories: diagnostic and therapeutic. On the diagnostic side, a doctor may recommend a D&C to investigate unusual uterine bleeding, bleeding after menopause, or abnormal cells found during a routine cervical cancer screening. The tissue removed is sent to a lab to check for conditions like precancerous thickening of the uterine lining, uterine polyps, or uterine cancer.
On the therapeutic side, a D&C is used to treat a condition rather than just investigate one. The most common reasons include:
- Miscarriage: Clearing tissue that remains in the uterus after a pregnancy loss to prevent infection or heavy bleeding.
- Incomplete abortion: Removing retained pregnancy tissue.
- Molar pregnancy: Removing an abnormal growth that forms instead of a typical pregnancy.
- Postpartum bleeding: Clearing placental tissue that stayed in the uterus after delivery.
- Polyps: Removing noncancerous growths from the cervix or uterus.
Anesthesia Options
Not everyone is put to sleep for a D&C. There are three main anesthesia options, and the choice depends on your health history and the reason for the procedure.
With general anesthesia, you’re fully asleep. With regional anesthesia (spinal or epidural), you’re awake but have no feeling from the waist down. With local anesthesia, only the cervix is numbed; you’re awake and have sensation everywhere else. If your procedure requires general or regional anesthesia, you’ll typically need to fast for eight hours beforehand, usually after midnight the night before. During the procedure, an anesthesiologist monitors your heart rate, blood pressure, breathing, and oxygen levels.
What the Procedure Feels Like
If you’re under general anesthesia, you won’t experience anything during the procedure itself. With local anesthesia, you may feel pressure or cramping as the cervix is dilated. The actual curettage portion is brief. Afterward, most people experience mild to moderate cramping similar to menstrual cramps, along with light spotting or bleeding that can last for several days.
Because a D&C is outpatient, you’ll spend some time in a recovery area after the procedure. If you had general or regional anesthesia, the medical team will wait until you’re fully alert before sending you home. You’ll need someone to drive you.
Recovery Timeline
Most people return to normal activities within one to two days. Physical recovery is generally quick since no incisions are made through the skin or abdominal wall. You can expect some cramping and light bleeding for up to two weeks. Your doctor will likely advise you to avoid using tampons and to hold off on sexual intercourse for a period of time to reduce the risk of infection, typically about two weeks.
Your next menstrual period may come earlier or later than expected, since the procedure removes the uterine lining and your body needs time to rebuild it. This is normal and doesn’t indicate a problem.
Risks to Be Aware Of
Serious complications from a D&C are uncommon, but they do exist. The primary risks include infection, heavy bleeding, and perforation of the uterus (when the instrument accidentally pokes through the uterine wall). Another rare complication is the formation of scar tissue inside the uterus, sometimes called Asherman syndrome, which can affect future periods and fertility.
Signs that something may be wrong after the procedure include a fever, bleeding heavy enough to soak through more than one pad per hour, severe abdominal pain that worsens rather than improves, or foul-smelling discharge. These symptoms warrant prompt medical attention.