What to Expect During a Dilation and Curettage, or a D&C

At Diana Health, we believe it’s important for you to have all of the knowledge you need to feel comfortable with your procedure, prior to it happening. If you are considering having or are scheduled for a Dilation & Curettage (D&C), below is some information that will help you better understand D&C’s and the routine pre and post-operative instructions. 

When you meet, your healthcare provider will review all of the necessary information. If you have any questions along the way, please ask. We care about you and want you to feel as comfortable as possible as you approach having this procedure. We are only a call away and will be with you throughout this process. Our doctors are experts at surgical procedures such as endometrial ablations, and you can rest assured that you are in good hands.

A Dilation & Curettage, typically known as a D&C, is a common surgical procedure that gynecologists perform. Even though physicians do these routinely, at Diana Health, we know that it is a unique experience for you anytime you have a procedure. That is why we are here to explain what a D&C is, why they are done, and to help you every step of the way if this is a procedure you are having.

Because a D&C involves clearing out the inside of the uterus, it may bring up strong emotions, especially if the procedure is connected with fertility or a miscarriage. Know that we are here to support your emotional health as well as your physical health. If you need someone to talk through these feelings, please reach out, and we can connect you with professionals who can support you. We care about you. 

If your Diana Health Care Team gives you any instructions that vary from what is below, please follow those instructions or modifications, as they know your medical history and the specifics about your upcoming procedure. 

What is a D&C? 

Dilation: The D in D & C stands for dilation. The first part of a D & C involves dilating the cervix (the opening of the uterus/womb), which is at the top of the vagina. Your doctor will use tools specially designed to help the cervix open. Initially, the tools used are extremely small and progressively get larger as the cervix opens. Remember, the cervix can dilate wide enough for a baby to come through during labor and delivery. To do this procedure, the cervix is only dilated a small amount of its total dilating potential. In certain circumstances, medication is given orally or vaginally before the procedure can be used to help the cervix dilate. 

Curettage: The C in D & C stands for curettage. The second part of a D & C involves using specially designed tools to curettage or remove the topmost layer of the lining of the uterus (the endometrium) and any contents inside the uterus. Your doctor will gently scrape the lining of the uterus with a metal curette or a suction device to get tissue samples from most of the uterine lining. The tissue comes out through the cervix that was just opened. When a vacuum device may help remove the tissue, the procedure is called a suction D & C. 

Why are D & C’s done?

A dilation and curettage procedure is done for several reasons. The most common reasons include abnormal uterine bleeding (also called vaginal bleeding since the blood exits the body through the vagina). Although an endometrial biopsy can be done in the office, which samples a small amount of endometrial tissue, a dilation and curettage allows for a more thorough sampling of the uterine lining to be performed. Sometimes a D & C can actually help treat abnormal bleeding. In other cases, it gives your doctor a better understanding of why the bleeding is happening so that they can address the underlying issue. 

Sometimes D & C’s are done because of tissue that is inside that is stuck inside of the uterus that needs to come out. For example, when a woman has a miscarriage, sometimes the tissue is retained inside the uterus and needs assistance getting out. A D & C can be done to remove this tissue. Uterine polyps or retained placenta can also be removed through curettage.

Other procedures:

In addition to a D & C, a procedure such as a hysteroscopy may be performed. In this case, the cervix is dilated, and a hysteroscope (small camera and light that goes inside of the uterus) is inserted into the uterus so that the doctor can see the lining of the uterus and its contents. Please refer to the content on hysteroscopy for more information. Other procedures, such as laparoscopy, tubal ligation, or procedures for urinary incontinence, can also be performed in conjunction with a D & C if needed. 

Preparing for a D & C: 

Prior to your surgery you will talk with your doctor as well as one of the Diana Health nurses or medical assistants to ensure that you understand how to best prepare for your procedure. Ideally, we like for you to be as healthy as possible prior to your surgery, so try to eat foods that nourish you, get adequate physical activity (but don’t start a vigorous new exercise routine), and get plenty of sleep. 

A prescription may be sent to your pharmacy for you to fill prior to your surgery so that you have the medication available once you return from the hospital. Also, you will want to bring a support person with you to the surgery so that they can talk to your healthcare provider after the procedure and be there to help you remember any follow-up instructions as well as drive you home when you are discharged. 

Additional preparations include:

• Most likely, you will be asked to not eat or drink anything after midnight the night prior to your surgery
• The morning of your surgery, take a shower but do not shave
• Remove any jewelry or piercings as these are best left at home
• If you wear contacts, bring or wear your glasses instead
• Leave all valuables at home
• Decide who will be driving you to and from your surgery
• Wear comfortable clothes that are not restrictive so that they can easily be put on after surgery and won’t be tight, especially around your abdomen and pelvis

Someone from anesthesia will talk with you before surgery and may give you medication to help you relax. 

What happens after a D & C?

Following the procedure, you will become more aware of your surroundings as you “wake up” from anesthesia or sedation. You may have uterine cramping and/or light vaginal bleeding or spotting after the procedure. You will receive discharge instructions, and a designated driver can take you home. 

Often cramping is well-controlled with medications such as ibuprofen. Your healthcare practitioner will also tell you how long to have “pelvic rest” with nothing in your vagina (including tampons and vaginal intercourse). This helps to decrease the risk of infection. If you start to have moderate or heavy bleeding, a fever, increased pain, or other problems, please contact us at Diana Health immediately. 

The removed tissue is typically sent to a pathologist to look at under a microscope. This allows you and your doctor to know more about the lining and contents of the uterus. For example, it helps them to know if the endometrial lining is “normal” for their age. It usually takes a few days to a week to get the results from pathology, and when they are received, your healthcare provider will review them with you. Make sure to keep your post-operative follow-up appointment with your Diana health provider. 

At Diana Health we care about your entire experience, from the moment you consider having a D&C until you are fully recovered. We are only a phone call away. Please reach out with any questions or if you have any unexpected symptoms or if you need any assistance. Never worry alone. We will be here with you each step of the way, through this procedure and as your health journey continues long beyond this procedure.