A D&C (dilation and curettage) is a short procedure, typically lasting about 30 minutes, where a doctor opens the cervix and removes tissue from the uterus. Whether you’re having one after a miscarriage, for heavy bleeding, or to diagnose an abnormality, the experience follows a similar pattern: a brief prep period, the procedure itself under sedation or general anesthesia, and a recovery that most people move through within a few days.
Why a D&C Is Done
The most common reasons fall into two categories. The first is pregnancy-related: completing a miscarriage when tissue remains in the uterus, or ending a molar pregnancy. The second is diagnostic or therapeutic: investigating abnormal uterine bleeding, removing polyps or fibroids, or sampling the uterine lining when cancer is a concern. Sometimes the procedure is paired with hysteroscopy, where a small camera is inserted into the uterus so the doctor can visually inspect the lining, check for abnormal areas, and remove polyps or fibroids at the same time.
Preparing the Day Before
Your provider will review your full medical history, current medications, and any allergies before scheduling. You’ll typically be told to stop eating and drinking the evening before the procedure. In some cases, your doctor may give you a medication (often placed vaginally or taken by mouth) to soften and widen your cervix ahead of time. Another option is a thin rod called a laminaria stick, inserted into the cervix hours before the procedure, which gradually absorbs moisture and expands to gently open it. Not everyone needs cervical preparation, but it makes dilation easier and reduces the force required during the procedure.
What Happens During the Procedure
Most D&Cs are performed under either general anesthesia or deep sedation. In a study of 229 patients undergoing D&C for pregnancy loss, about 72% received general anesthesia and 28% received deep sedation. With general anesthesia, you’re fully asleep. With deep sedation, you’re in a twilight state and unlikely to remember the procedure. Either way, you won’t feel the steps as they happen.
The procedure itself has two phases. First, the doctor gradually opens your cervix using a series of smooth, tapered rods, starting with the smallest size and working up. Once the cervix is dilated enough, a thin instrument called a curette is inserted through the cervical opening and into the uterus. For pregnancy-related procedures, a plastic curette connected to gentle suction (either manual or electric) is typically used to remove tissue. For diagnostic purposes, a small metal curette may be used to collect a tissue sample from the uterine lining. The curette is moved methodically across the uterine walls to ensure thorough sampling or removal. The operative time averages around 27 to 30 minutes, though the actual tissue removal portion is shorter than that once you account for setup and anesthesia.
The First Hours After
You’ll spend time in a recovery area while the anesthesia wears off. Grogginess, mild nausea, and some cramping are all normal during this window. If you had sedation or general anesthesia, you’ll need someone to drive you home. Most people leave the facility the same day, often within a couple of hours of the procedure ending.
Cramping similar to period pain is the most common complaint in the first day or two. Over-the-counter pain relievers typically manage it well. Light vaginal bleeding or spotting is also expected and can continue for several days to a couple of weeks. The bleeding is usually lighter than a regular period and tapers gradually.
Activity Restrictions and Recovery
For the first two to three days (or longer, depending on your provider’s instructions), you’ll be told to avoid tampons, douching, and intercourse. This gives the cervix time to close and reduces the risk of infection. Strenuous activity and heavy lifting are also off-limits during this window. Most people feel well enough to return to normal daily activities within a day or two, though your provider may recommend taking it easy a bit longer depending on your situation.
Your first period after a D&C generally returns within two to six weeks. It may be slightly different from your usual cycle, arriving a bit earlier or later, or with lighter or heavier flow than you’re used to. This usually normalizes over the following cycle or two.
Warning Signs to Watch For
Some bleeding and cramping are part of normal recovery, but certain symptoms signal a problem. Contact your provider or go to an emergency room if you experience:
- Heavy bleeding: soaking through two maxi pads per hour for two consecutive hours
- Fever: a temperature above 100.4°F, or chills
- Severe pain: abdominal or back pain that doesn’t improve with pain medication
These can indicate infection, retained tissue, or, rarely, a perforation of the uterine wall.
Risks and How Common They Are
Serious complications from a D&C are uncommon. Uterine perforation, where an instrument passes through the uterine wall, occurs in roughly 0.3% of premenopausal women and about 2.6% of postmenopausal women undergoing D&C for non-pregnancy reasons. For first- and second-trimester pregnancy-related procedures, the perforation rate is around 0.5%. Most perforations are small and heal on their own without surgery.
Infection is another potential risk, though it’s also infrequent and typically treated with antibiotics. A less common but more significant long-term concern is intrauterine adhesions, sometimes called Asherman syndrome, where scar tissue forms inside the uterus after the procedure. This can affect future periods and fertility. The risk is higher when D&C is performed for retained tissue after pregnancy, particularly if repeated procedures are needed.
Getting Your Results
If tissue was sent for pathology, which is standard for diagnostic D&Cs and common after miscarriage, results typically take one to two weeks. Your provider will usually schedule a follow-up appointment or call to discuss the findings. For pregnancy loss, pathology may help identify whether there was a chromosomal or structural cause. For abnormal bleeding, the results help rule out or confirm conditions like endometrial hyperplasia or cancer, and they guide the next steps in your care.
The Emotional Side
If your D&C is related to a miscarriage, the emotional recovery often takes longer than the physical one. Grief, sadness, and even relief are all normal responses, and they can come in waves for weeks or months. Hormonal shifts after pregnancy loss can intensify mood changes in the first few weeks. There’s no expected timeline for emotional healing, and many people find it helpful to talk with a counselor, a support group, or someone who has been through a similar experience.