A D&C, short for dilation and curettage, is a surgical procedure that removes tissue from the inner lining of the uterus. It involves two steps: widening (dilating) the cervix, then using a thin instrument or suction device to clear tissue from inside the uterus. A D&C is one of the most common gynecological procedures, performed both to diagnose conditions like abnormal bleeding and to treat situations like miscarriage.
Why a D&C Is Performed
A D&C serves two broad purposes: diagnostic and therapeutic. On the diagnostic side, your doctor may recommend one if you’re experiencing abnormal uterine bleeding, unusually heavy periods, bleeding after menopause, or if earlier tests like an ultrasound showed something unusual in the uterine lining. The removed tissue gets sent to a lab where a pathologist examines it under a microscope, checking for abnormal cells, polyps, or other conditions. Results typically come back within one to two weeks.
On the therapeutic side, a D&C is commonly used after a miscarriage to remove tissue that hasn’t passed on its own. This is sometimes called an “incomplete miscarriage,” and leaving tissue behind can cause prolonged bleeding or infection. A D&C is also used after childbirth if fragments of the placenta remain in the uterus, or to remove uterine polyps.
D&C for Miscarriage
If you’ve had a miscarriage, a D&C is one of three main options. The others are waiting for tissue to pass naturally (called expectant management) or taking medication to help the uterus empty. Each approach has tradeoffs, and the right choice depends on how far along the pregnancy was, how much tissue remains, whether there’s active bleeding, and your own preference.
A D&C offers the most predictable timeline. The procedure is scheduled, completed in one visit, and the uterus is confirmed empty before you leave. Expectant and medical management can take days to weeks and sometimes end up requiring a D&C anyway if tissue doesn’t fully pass. On the other hand, a D&C is a surgical procedure with its own risks, which matters when the alternatives may work well on their own. Many people choose a D&C because they want closure and a defined endpoint during an already difficult time.
How the Procedure Works
A D&C is typically an outpatient procedure, meaning you go home the same day. Before the procedure, you’ll be asked to stop eating and drinking, usually starting the night before if general or regional anesthesia is planned. Your doctor may also give you medication or use a thin rod called a laminaria to gradually soften and open your cervix in advance.
For anesthesia, there are three common options:
- General anesthesia: you’re fully asleep during the procedure.
- Regional anesthesia (like an epidural): you’re awake but have no feeling from the waist down.
- Local anesthesia: only the cervix is numbed, and you’re awake with sensation everywhere else.
Which type you receive depends on the reason for the procedure and your medical history. If the D&C is being done under local anesthesia, fasting requirements are usually less strict.
Once anesthesia takes effect, the doctor inserts a speculum (the same instrument used during a Pap smear) and then widens the cervix by passing a series of progressively larger thin rods through the opening. With the cervix dilated, the doctor removes uterine tissue using one of two methods: a spoon-shaped scraping instrument called a curette, or a suction device that vacuums tissue out. Many providers now prefer suction because it tends to be gentler on the uterine walls. The entire procedure usually takes 10 to 15 minutes.
What Recovery Looks Like
Most people spend an hour or two in a recovery area afterward while the anesthesia wears off. You’ll need someone to drive you home if you had general anesthesia or sedation. Mild cramping similar to period cramps is normal for a day or two, and light bleeding or spotting can last up to two weeks.
Most people return to normal activities within one to two days, though strenuous exercise is usually best postponed for about a week. To reduce the risk of infection while the cervix is closing, you’ll typically be told to avoid using tampons, having intercourse, or putting anything in the vagina for about two weeks. Your period generally returns within four to six weeks.
Risks and Complications
A D&C is considered safe, and serious complications are uncommon. The main risks include infection, heavy bleeding, and uterine perforation (when the instrument pokes through the uterine wall). Perforation sounds alarming but usually heals on its own without further treatment.
One complication worth knowing about is the formation of scar tissue inside the uterus, a condition called Asherman syndrome. Scar tissue can cause lighter periods, missed periods, or fertility problems down the road. Research published in the Journal of Obstetrics and Gynaecology Canada found the rate of Asherman syndrome after a D&C was about 0.7%, and every case in that study involved sharp curettage (the scraping method) rather than suction. Women who had repeat D&C procedures were at higher risk. In that same study, no cases of Asherman syndrome occurred when suction aspiration or medication alone was used to manage miscarriage.
This is one reason many providers have shifted toward suction curettage when a D&C is needed, particularly for miscarriage management. If you’re concerned about this risk, it’s reasonable to ask your provider which technique they plan to use.
After the Procedure: What Results Mean
If your D&C was done for diagnostic reasons, the tissue removed is sent to a pathology lab. The pathologist looks for signs of abnormal cell growth, precancerous changes, polyps, or hormonal imbalances affecting the uterine lining. These results help your doctor determine next steps, whether that’s reassurance that everything looks normal, monitoring, or further treatment. Expect to hear back within one to two weeks, though timing varies by lab.
If the D&C was done after a miscarriage, tissue may still be sent to the lab, sometimes to look for chromosomal abnormalities that could explain the pregnancy loss. This information can be especially useful for people who have experienced recurrent miscarriages.