What Is a Dilation and Curettage?
A dilation and curettage is a surgical procedure that can be used for a few different purposes, such as diagnosing abnormal bleeding or other conditions affecting the uterus, as well as for removing tissue from the uterus after a miscarriage. The procedure starts with the dilation, or expansion, of the cervix, which is the long narrow end of the uterus that connects the rest of the uterus to the vagina. Once that process is complete, the doctor will use a narrow spoon-shaped instrument called a curette to gently scrape and remove the tissue that lines the uterus. Generally, you don’t need to worry about whether or not you’ll be able to get pregnant after you’ve undergone a D&C. “If a woman is afraid a D&C will affect her fertility, [I] remind her that she shouldn’t be,” says Shahin Ghadir, MD, an OB/GYN and reproductive endocrinologist with the Southern California Reproductive Center. “A D&C procedure done in the appropriate hands should be done extremely gently and can be done with no harm to the uterus or woman.”
What Is the Recovery After a D&C Like?
Like with any surgery, there is a recovery period to undergo. The type of surgery and anesthesia used will likely affect your recovery process. The type of anesthetic used during the surgery will affect if you can go home the same day, or if you’ll need to spend the night. If you receive local anesthesia, you might only need to rest after the procedure for a couple of hours before having someone drive you home. But if you undergo regional or general anesthesia, you may need to spend some time in the recovery room, where they’ll monitor your blood pressure, breathing, and heart rate. Depending on how you do and the anesthesia that was used, you may be discharged to go home or you may be moved to a hospital room. After that, you’ll need to let your body heal. “During the recovery process from a D&C, a woman should expect to generally experience spotting and continued cramping,” says Dr. Ghadir. That’s because the uterus is starting to return to its normal shape and size. “Otherwise, there are not many symptoms during this period." Most of the time, D&Cs are perfectly safe, according to the American Society for Reproductive Medicine (ASRM). But the ASRM notes there are some risks to be aware of. In addition to heavy bleeding afterward, other possible complications can include infection, perforation of the uterus, and scar tissue developing inside the uterus. If you start to experience significant and worsening abdominal pain, it could be a sign that something’s wrong. Dr. Ghadir also suggests watching out for other warning signs such as fever and chills or heavy continuous bleeding, as those can be warning signs that you may need additional care. If you do experience anything outside the norm or worry that something seems wrong, notify your healthcare provider right away.
How Long After a D&C Can I Conceive?
You might be eager to start trying to get pregnant (or get pregnant again) after a D&C. However, your healthcare provider may advise you to wait a little while for your body to heal and prepare itself for a pregnancy. You’ll need to avoid having vaginal intercourse for at least four weeks, but it may take longer for complete healing after a D&C. Rudy Quintero, MD, a reproductive endocrinologist, and founder and medical director of CARE Fertility, says that having a D&C shouldn’t have any effect on your ability to get pregnant in the future, except in rare conditions. For example, you can develop intrauterine adhesions or scar tissue in the uterus which is sometimes called Asherman syndrome. This could affect your ability to conceive.
Pregnancy Concerns After a D&C
While undergoing a D&C may not affect your ability to get pregnant again, research suggests that a history of D&Cs may increase the risk of experiencing a preterm delivery with a future pregnancy. A 2016 meta-analysis examined the rate of preterm births among women who had undergone a D&C for a first-trimester miscarriage or pregnancy termination. They found that these women were more likely to deliver their future babies early. The study researchers urged caution about opting for a D&C without considering other possible options. “Future cases of preterm birth could potentially be prevented by avoiding unneeded D&C,” the researchers wrote. “Non-invasive management options, such as expectant management or medical management in case of miscarriage, and medical management in case of termination of pregnancy, have been proven to be a good alternative.” If you have any questions about if a D&C is the right procedure for your situation, talk to your healthcare provider. They can advise you on the best course of action based on your medical history and future plans for getting pregnant.
A Word From Verywell
A D&C is a pretty common procedure, but it’s common to be a little nervous about undergoing one—and wondering how it will affect you afterward. Experts say that in most cases, a D&C shouldn’t affect your ability to get pregnant in the future. They advise waiting for one to three natural menstrual cycles before trying to conceive. Don’t hesitate to bring up any concerns you may have with your healthcare provider.
