A D&C, short for dilation and curettage, is a minor surgical procedure that removes tissue from the lining of the uterus. It involves two steps: widening (dilating) the cervix, then using a spoon-shaped instrument called a curette to scrape or suction tissue from inside the uterus. It’s one of the most common gynecological procedures, used both to diagnose problems and to treat them.
Why a D&C Is Performed
There are two broad categories of reasons for a D&C: diagnostic and therapeutic. On the diagnostic side, a doctor may recommend the procedure to investigate unexplained uterine bleeding, to check for abnormal cells in the uterine lining, or to evaluate growths like polyps. The tissue removed is sent to a lab for analysis, which can help identify or rule out conditions including endometrial cancer.
On the therapeutic side, a D&C is frequently used after a miscarriage. When pregnancy tissue remains in the uterus after an incomplete or missed miscarriage, a D&C clears it out to prevent infection and heavy bleeding. It’s also used to remove retained tissue after childbirth, to treat certain types of abnormal bleeding, and to remove uterine polyps.
A D&C isn’t the only option for managing a miscarriage. Medication can help the body pass the tissue on its own, and some people choose to wait and let it happen naturally. Your doctor can walk you through the tradeoffs of each approach based on your specific situation.
What Happens During the Procedure
A D&C is typically done as an outpatient procedure, meaning you go home the same day. Depending on the circumstances, you may receive general anesthesia (fully asleep), regional anesthesia (numb from the waist down), or local anesthesia (numbing only the cervix). If general or regional anesthesia is used, you’ll need to fast for about eight hours beforehand, usually starting at midnight the night before.
You’ll lie on your back with your feet in stirrups. The doctor begins with a physical exam to assess the size and position of your uterus, then places a speculum in the vagina to see the cervix. The cervix is gently opened using a series of progressively larger dilators, starting with the smallest size that fits and working up. Once the opening is wide enough, a curette is inserted through the cervix and into the uterus.
The curette is moved along the walls of the uterus in a rotating motion, scraping tissue from the lining. In many cases, suction (manual or electric) is applied at the same time to help remove the tissue. The doctor can tell the procedure is complete when the instrument meets a slightly gritty texture against the uterine wall, which signals the lining has been fully sampled or the tissue has been cleared. The whole process usually takes only 15 to 30 minutes. Ultrasound is sometimes used during the procedure for guidance, particularly if the uterine anatomy is unusual or dilation is difficult.
Recovery and What to Expect
Most people return to normal activities within one to five days. Mild cramping, similar to period cramps, and light spotting or bleeding for a few days afterward are both normal. Over-the-counter pain relievers like ibuprofen are generally enough for any discomfort.
The most important recovery rule is to avoid putting anything in the vagina until your doctor clears you. That means no tampons, no sexual intercourse, and no douching, typically for about a week. The cervix stays slightly open after the procedure, and until it returns to its normal size, bacteria can enter more easily and cause infection. Use pads for any bleeding during this window.
Risks and Complications
A D&C is considered safe, and serious complications are uncommon. The primary risks include uterine perforation (the instrument accidentally poking through the uterine wall), infection, and heavy bleeding. Most perforations heal on their own without further treatment.
The complication that gets the most attention in the long term is Asherman syndrome, a condition where scar tissue (adhesions) forms inside the uterus after the procedure. These adhesions can cause lighter periods, pain, or difficulty with future pregnancies. The risk varies significantly depending on the circumstances. About 13% of people develop adhesions after a first-trimester procedure, and the rate climbs to around 30% after a D&C for a late miscarriage. The risk also increases substantially, up to roughly 23%, when a repeat procedure is needed within two to four weeks of the first one.
Signs that something isn’t right after a D&C include fever, heavy bleeding that soaks through a pad in an hour or less, worsening pain rather than improving pain, and foul-smelling discharge. These symptoms warrant a prompt call to your doctor.
How to Prepare
Before the procedure, let your doctor know about every medication and supplement you take, including over-the-counter options. Blood-thinning medications and aspirin may need to be stopped ahead of time to reduce bleeding risk. Your doctor will tell you how far in advance to stop and when it’s safe to restart.
Since you may be groggy from anesthesia afterward, arrange for someone to drive you home. Most people feel well enough to eat, move around, and handle light activities by the next day.