Dilatation & Curettage (D&C) is a surgical procedure used in abortion. D&C has other uses as well in diagnosing, treating medical conditions that affect the uterus.
In abortion, D&C is used not as an exclusive procedure but as a supporting procedure when there is pregnancy tissue inside the uterus after an incomplete abortion due to medical abortion pills or Manual Vaccum Aspiration (MVA). It is important to remove all the remaining pregnancy tissues from the uterus because an incomplete abortion can cause infections later on.
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Do you need to be hospitalized for D&C?
D&C does not require hospitalization. However, you will be asked to remain in the hospital for a few hours after the procedure. All D&C procedures are done under anesthesia. After the procedure, the effects of anesthesia can still persist and thus time is needed for you to recover well. Also, monitoring is needed to ensure that you have not developed any complications such as heavy bleeding after the procedure.
What exactly happens during D&C?
You will be given the medicine Misoprostol to help the cervix to dilate. Some doctors give this medicine the day before the procedure, while some give it a few hours before the procedure. Having this medicine will soften your cervix and it will start opening up gradually. Thus by the time the procedure has to happen your cervix will be dilated to a good length.
For the procedure, you will be seated on the surgeon’s table like how you sit during a pelvic examination. That is, you will be lying down on your back with your legs spread wide open. Your legs will be resting and supported on stirrups.
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You will also be given anesthesia. Anesthesia is needed so that you will not feel any pain or discomfort during the procedure. Usually, general anesthesia (wherein you become unconscious) is not used for D&C.
Then the doctor or nurse will insert a speculum into your vagina. A speculum is like a metal tong, but a medical one. It is used to open up the vagina such that the doctor can get a larger view of the insides of the vagina. You need not worry about pain during this step. Usually, there is no pain. You will only feel a stretchy sensation.
After this step, the doctor or nurse will clean your vagina and cervix with an antiseptic solution. Following which they will inject the local anesthetic into your cervix. Don’t get scared at the thought of getting an injection in your cervix. It only hurts like how a mosquito would bite you.
Once the local anesthetic starts to work and they are sure that you are numb in the area, they will hold your uterus in place by grasping the cervix with an instrument.
The next step is dilation (further opening). Here a series of thicker rods are inserted into your cervix to dilate your cervical canal further. The cervical canal connects the uterus to the vagina through the cervix. Why dilation is important is because a dilated cervical canal minimizes any injury to the cervix during D&C.
On getting adequate dilation, then the dilation rods are removed and the cervix is held in place with a clamp. Following this, the doctor will insert a spoon-shaped instrument with sharp edges called a curette into your uterus and scrape off the pregnancy tissue.
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Recovery after D&C:
Once the doctor has ensured that there is no complication following the procedure, you can go home within the same day of the procedure.
For the next few days, you will have occasional bleeding and cramps. You can take the medications prescribed by the doctor to manage these.
You are at a high risk of developing an infection in the immediate days after the procedure if you insert anything into your vagina. Thus using tampons or menstrual cups is not advised. You can use them once your cervix is back to normal. Also, refrain from sexual intercourse till you heal fully.
Your periods will be delayed for the next month. This is not unusual as your uterus needs time to regenerate a new lining.
You can resume all your day-to-day activities within three days following the procedure.
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