A D&C (dilation and curettage) is a procedure where the cervix is gently opened and tissue is removed from the lining of the uterus. Women may need one for a range of reasons, from managing a miscarriage to diagnosing the cause of abnormal bleeding. It’s one of the most common gynecological procedures, and the specific reason behind it shapes everything from how it’s performed to what recovery looks like.
After a Miscarriage or Early Pregnancy Loss
The most well-known reason for a D&C is to treat a miscarriage. When a pregnancy ends on its own but the body doesn’t fully pass all the tissue, it’s called an incomplete miscarriage. In some cases, the pregnancy stops developing but the tissue remains in the uterus entirely, known as a missed miscarriage. Both situations can lead to heavy bleeding, infection, or other complications if left untreated.
Not every miscarriage requires a D&C. Many women can wait for the tissue to pass naturally (expectant management) or take medication to help the process along. A D&C becomes the recommended option when those approaches don’t work, when bleeding is heavy enough to cause instability, when there are signs of infection, or when a woman has a health condition like severe anemia that makes significant blood loss risky. Some women also choose a D&C because they prefer a definitive, faster resolution rather than waiting days or weeks for the process to complete on its own.
Treating a Molar Pregnancy
A molar pregnancy happens when something goes wrong during fertilization, resulting in abnormal tissue growing in the uterus instead of a viable pregnancy. This tissue can’t develop into a baby and must be removed to prevent serious complications, including a rare form of cancer. A D&C is the standard treatment. After the procedure, hormone levels are monitored for about six months to make sure no abnormal tissue remains.
Removing Retained Tissue After Delivery
After a vaginal delivery or cesarean section, small fragments of the placenta can sometimes stay attached to the uterine wall. These retained fragments can cause persistent bleeding, cramping, and infection in the weeks following birth. When the tissue doesn’t pass on its own, a D&C may be needed to clear the uterus and stop the bleeding.
Diagnosing Abnormal Uterine Bleeding
Outside of pregnancy, one of the primary reasons for a D&C is to figure out why a woman is bleeding abnormally. This includes periods that are unusually heavy, bleeding between periods, or bleeding after menopause. These symptoms can point to a range of conditions, from harmless hormonal shifts to something that needs treatment.
In most cases, doctors start with a simpler office procedure called an endometrial biopsy, where a thin tube collects a small tissue sample from the uterine lining. A D&C becomes necessary when that initial biopsy can’t collect enough tissue for a diagnosis, when a woman can’t tolerate the office procedure, when the cervix is too narrow to pass the sampling device through, or when abnormal bleeding persists even after a biopsy comes back normal.
During a D&C for diagnostic purposes, doctors often combine it with hysteroscopy, inserting a small camera into the uterus to visually inspect the lining. This allows them to spot and sometimes remove polyps or fibroids at the same time, turning a diagnostic procedure into a therapeutic one.
Screening for Uterine Cancer
A D&C can detect precancerous changes and endometrial cancer. Research published in BMJ Open found that out of 100 women with endometrial cancer, D&C correctly identified 77 of them. Out of 100 women without cancer, it correctly cleared 99. These numbers make it a reliable tool when initial testing raises concerns, particularly for identifying a precancerous condition where the uterine lining grows abnormally thick. If an office biopsy finds precancerous cells, a D&C may follow to get a more thorough sample and rule out cancer that the smaller biopsy could have missed.
Stopping Severe Uterine Bleeding
Beyond diagnosis, a D&C can serve as an emergency treatment. When a woman experiences dangerously heavy uterine bleeding that hasn’t responded to medication, physically removing the thickened uterine lining can stop the bleeding quickly. This is less common than the diagnostic use but can be necessary when bleeding becomes a medical emergency.
What the Procedure Involves
A D&C is typically an outpatient procedure, meaning you go home the same day. It’s done in an operating room under either general anesthesia (you’re fully asleep) or deep sedation. The doctor gradually widens the cervix using small dilating instruments, then uses a suction device or a surgical tool to gently remove tissue from the uterine lining. For pregnancy-related D&Cs, suction is the most common method. The whole procedure usually takes 15 to 30 minutes.
Afterward, you’ll spend time in a recovery area while the anesthesia wears off. You’ll need someone to drive you home. Some cramping and light bleeding in the days that follow is normal.
Risks Worth Knowing About
A D&C is generally safe, but it does carry some risks. The most significant long-term concern is the formation of scar tissue inside the uterus, known as Asherman syndrome. This can affect future periods and fertility. The risk varies depending on timing and context: roughly 13% of women develop some adhesions after a first-trimester procedure, and the rate climbs to about 30% after a D&C for a late miscarriage. Women who need a repeat procedure within two to four weeks face rates as high as 23%. These numbers don’t mean the scarring will be severe enough to cause symptoms in every case, but they’re worth discussing with your doctor if future pregnancies are important to you.
Other possible complications include infection, heavy bleeding during the procedure, and very rarely, a small tear in the uterine wall. Most women recover without any of these issues.
What Recovery Looks Like
Recovery time depends on the reason for the procedure and the type of anesthesia used. Most women feel well enough to return to normal activities within a day or two, though some mild cramping and spotting can last for a week or more. Your doctor will typically advise avoiding tampons and sexual intercourse for a period after the procedure to reduce infection risk. If the D&C was done to diagnose a condition, you’ll usually get tissue results within one to two weeks, which will guide any next steps in your care.