When a doctor mentions Dilation and curettage, many parents immediately think of pain, anaesthesia, and fear about future fertility—especially if the Dilation and curettage is being suggested after a miscarriage. That reaction makes sense. You may still be bleeding, still processing the shock, and now you are being asked to consider a procedure.

The reassuring part? Dilation and curettage is a commonly performed uterine procedure, usually quick, and in most cases recovery is straightforward. The key is knowing why it is offered, what alternatives exist, what risks to watch for, and what a normal healing timeline looks like.

Dilation and curettage: what it is and why it may be offered

What “dilation” and “curettage” mean in simple words

Dilation and curettage has two parts:

Dilation: gently opening the cervix (the narrow passage at the lower end of the uterus).
Curettage: removing tissue from the uterine cavity.

Today, the “curettage” step is most often done by suction aspiration using a thin cannula (a small tube). In some situations, a spoon‑shaped instrument called a curette may be used briefly to clear small remaining fragments.

Look after your family’s health

Download Heloa

Use your phone’s camera to scan the QR code and download Heloa

Veillez sur la santé de votre famille

Try Heloa

What a Dilation and curettage is meant to do

A Dilation and curettage can:

Remove retained tissue (after miscarriage, after abortion, or after delivery)
Control bleeding related to retained tissue
Lower the risk of infection when tissue remains
Collect an endometrial sample (uterine lining) for laboratory analysis (histopathology)

If tissue is sent for pathology, the report may confirm pregnancy tissue, benign endometrium, a polyp, or—more rarely—abnormal changes that need follow‑up.

Names you may hear in the hospital

Depending on the team and setting, Dilation and curettage may be described as:

D&C
suction curettage
vacuum aspiration
uterine evacuation

When Dilation and curettage can be helpful

After miscarriage: when the uterus has not emptied completely

Sometimes the uterus expels all tissue naturally. Sometimes it doesn’t. Ultrasound may show retained products of conception (RPOC), bleeding may continue, or hCG may fall too slowly.

A Dilation and curettage is commonly considered for:

Incomplete miscarriage (tissue remains)
Missed miscarriage (pregnancy stopped developing but tissue has not passed)
persistent bleeding, pain, or slow‑declining hCG

You might ask: Is this being suggested because something is wrong with my body? Not necessarily. In many cases, it is simply the safest way to help the uterus finish what it started.

Heavy bleeding, severe pain, or fever: situations where speed matters

A faster approach is often chosen when:

bleeding is heavy (pads soaking quickly, large clots, weakness)
pain is intense or worsening
fever occurs (≥ 38°C / 100.4°F), chills, foul‑smelling discharge, or feeling very unwell

In these situations, delaying can increase risk of anaemia or endometritis (infection of the uterine lining).

RPOC after miscarriage, abortion, or delivery

Retained tissue can keep the uterus from contracting well, causing prolonged bleeding and cramps. Dilation and curettage using suction is frequently used, sometimes with ultrasound guidance or hysteroscopy if tissue is focal or adherent.

After childbirth: postpartum bleeding and retained placenta

Postpartum, the uterus is larger and more vascular (more blood flow), so bleeding risk is higher. If retained placenta is suspected, Dilation and curettage may be done in a setting ready to manage bleeding promptly. Tell the anaesthesia team if you are breastfeeding so medicines can be chosen accordingly.

Abnormal uterine bleeding and assessing the uterine lining

For heavy or irregular bleeding, Dilation and curettage may be used to obtain a larger sample than an office biopsy, especially if earlier sampling was insufficient. It can also remove some lining tissue and sometimes reduces bleeding temporarily while the cause is investigated.

Polyps, small fibroids, suspected hyperplasia

A Dilation and curettage can support diagnosis of endometrial hyperplasia and sometimes remove tissue linked to polyps or small submucosal fibroids. When a focal lesion is suspected, hysteroscopy (camera in the uterus) improves accuracy because the clinician can see and target the area.

Molar pregnancy (when relevant)

If a molar pregnancy is suspected, Dilation and curettage is typically performed to evacuate abnormal placental tissue. Follow‑up relies on serial hCG monitoring to confirm complete resolution.

Alternatives to Dilation and curettage (especially after miscarriage)

Expectant management (watchful waiting)

Waiting for natural passage may be an option, especially in the first trimester, if:

you are stable and feel well
there is no fever
bleeding is moderate and not increasing

The downside is unpredictability. Some people pass tissue quickly, others have prolonged bleeding or incomplete evacuation.

Medication (misoprostol)

Misoprostol helps the uterus contract and expel tissue. It can be effective, but it may involve:

strong cramping
heavier bleeding during expulsion
a chance of incomplete outcome needing suction evacuation

Protocols differ (dose, route, timing). Follow your clinician’s instructions.

Suction aspiration versus “sharp” curettage

If a procedure is needed, suction aspiration is usually preferred as it is generally gentler for the endometrium. A small amount of curettage may be used if fragments are firmly attached.

What usually shapes the decision

Clinicians consider:

bleeding, pain, fever
your past uterine procedures (previous D&C, caesarean, myomectomy)
ability to arrange follow‑up
your preference: quick resolution versus avoiding a procedure

Types of Dilation and curettage and technique options

Diagnostic vs therapeutic

Diagnostic Dilation and curettage: aims to collect endometrial tissue for analysis.
Therapeutic Dilation and curettage: aims to remove retained tissue and treat bleeding/infection risk.

Manual vacuum aspiration (MVA) and suction D&C

Many early‑pregnancy procedures use suction through a plastic cannula. MVA may be done in a clinic setting for selected cases.

Dilation and curettage with hysteroscopy vs “blind” D&C

A “blind” D&C does not use direct visualisation. With hysteroscopy, the clinician can view the uterine cavity and target a polyp, fibroid, or focal retained tissue—often improving precision.

Office-based vs operating theatre

Some Dilation and curettage procedures can be performed with local anaesthesia and light sedation. Operating theatre is more common when:

deeper sedation/general anaesthesia is planned
hysteroscopy is needed
postpartum bleeding is significant
the case is complex

Who needs extra caution

When Dilation and curettage is not suitable

The key contraindication: a viable intrauterine pregnancy when the goal is to continue it.

When the plan may be modified

Your team may adapt the plan if there is:

active pelvic infection (unless evacuation is part of treatment)
bleeding disorder
anticoagulant/antiplatelet use

Factors that increase technical difficulty

congenital uterine anomalies
prior uterine surgery or multiple procedures
postpartum uterus (more vascular, perforation risk can be higher)

Preparing for a Dilation and curettage

Consultation and ultrasound

Typically, the team confirms the indication via:

clinical assessment
pelvic ultrasound (often transvaginal)
discussion of alternatives

Be ready to describe bleeding (pads/hour), clots, pain pattern, fever/chills, and prior uterine procedures.

Tests that may be advised

Depending on the reason:

hCG testing
complete blood count (anaemia check)
blood group and Rh status (Rh-negative people may need Rh immunoglobulin)
pre‑anaesthesia review (allergies, medicines, prior reactions)

Cervical preparation

To make dilation gentler, options include:

misoprostol a few hours before
osmotic dilators in selected cases
gradual dilation during the procedure

Fasting and practical planning

If sedation or general anaesthesia is planned, you will need fasting (as advised). Arrange a ride home and plan rest for the day.

Consent: what you should clearly know

You are entitled to understand:

why Dilation and curettage is advised
alternatives
anaesthesia plan
risks and expected recovery
follow‑up and warning signs

Anaesthesia and comfort options

Local anaesthesia (paracervical block)

Local anaesthetic is injected around the cervix. The sting is brief, after that, many people mainly feel pressure and cramping.

Sedation vs general anaesthesia

Sedation: relaxed and drowsy, breathing on your own.
General anaesthesia: fully asleep.

Choice depends on urgency, setting, your medical history, and comfort.

Pain control after the procedure

Common options:

ibuprofen/naproxen (if suitable)
paracetamol (acetaminophen)
heat pad

Pain that worsens instead of improving should be assessed.

How Dilation and curettage happens: step by step

Check-in and monitoring

Identity and plan are confirmed. Vitals are monitored, especially with sedation/general anaesthesia.

Cervical dilation

A speculum is used to visualise the cervix. The cervix is stabilised and opened gradually.

Tissue removal and pathology

Suction removes tissue, occasionally a brief additional step clears small fragments. Tissue may be sent for pathology.

Ultrasound guidance or hysteroscopy

Used when anatomy is uncertain, bleeding risk is higher, or a focal lesion is suspected.

Duration

The procedure is often 15–30 minutes, but the total visit is longer due to preparation and recovery. Most people go home the same day.

Recovery after Dilation and curettage

What you may feel

cramping like period pain
light to moderate bleeding for a few days, spotting up to 1–2 weeks
fatigue, especially after anaesthesia

Symptoms should steadily improve.

Activity and return to work

Many return to daily activities within 1–2 days, but emotional recovery—particularly after pregnancy loss—may take longer.

Pelvic rest

Many teams suggest avoiding sex, tampons, and menstrual cups for about 1–2 weeks or until bleeding stops, to reduce infection risk. Avoid pools/hot tubs during active bleeding.

Antibiotics and Rh immunoglobulin

antibiotics may be given more often in pregnancy‑related or postpartum procedures
Rh immunoglobulin may be offered if you are Rh-negative and pregnancy tissue was involved

Follow-up and results

Pathology results

Often available within about a week, if tissue was sent.

Ultrasound and/or hCG monitoring

Follow-up is often in 1–2 weeks. In pregnancy-related cases, hCG may be monitored until negative. Slow decline or plateau can suggest retained tissue and needs review.

Risks and complications

Common short-term effects

Cramping, light bleeding, fatigue, mild nausea.

Heavy bleeding, infection, retained tissue

heavy bleeding can occur if tissue remains or uterus doesn’t contract well
endometritis may present with fever, worsening pain, foul discharge
retained tissue may cause persistent bleeding and slow hCG fall

Uterine perforation and cervical injury

Uncommon but recognised risks, more likely postpartum or with complex anatomy. Many small perforations heal without intervention, but significant bleeding requires urgent care.

Intrauterine adhesions (Asherman syndrome)

Uncommon, especially with suction methods, but risk increases with repeated procedures or infection. Watch for:

very light/absent periods
cyclic pain with minimal bleeding
difficulty conceiving or recurrent loss

Diagnosis uses saline sonography or hysteroscopy, treatment is often hysteroscopic removal.

Anaesthesia-related side effects

Grogginess, nausea, sore throat (after general anaesthesia), rare allergic reactions.

When to seek care after Dilation and curettage

Seek urgent assessment if:

you soak one large pad per hour for 2 hours in a row, or pass very large clots
fever ≥ 38°C/100.4°F, chills, worsening pelvic pain, foul discharge
dizziness, fainting, shortness of breath, palpitations (possible anaemia)
persistent pregnancy symptoms or concerns about incomplete evacuation

Periods, contraception, and trying again

Fertility after Dilation and curettage

Most people can conceive again. For the majority, Dilation and curettage does not reduce fertility, especially when suction is used.

When periods return

After miscarriage-related D&C, periods often return in 4–8 weeks.

Ovulation can happen before the first period

Pregnancy is possible before the first period returns, so contraception matters if you want to wait.

Planning another pregnancy

Many clinicians suggest trying again once bleeding has stopped and you feel ready. Some prefer waiting for one normal period to help date the next pregnancy.

Dilation and curettage after miscarriage: space for emotions

Some parents choose Dilation and curettage for predictability and quicker physical closure. Others prefer medication or waiting. The “right” choice depends on safety and what you can cope with at the moment.

Emotional recovery deserves attention. If sleep is severely affected, anxiety is constant, or grief feels unmanageable, consider support from an OB‑GYN, GP, counsellor, or perinatal mental health professional.

Key takeaways

Dilation and curettage is a common procedure to dilate the cervix and remove or sample tissue from the uterus, most often using suction.
It may be offered after miscarriage when tissue remains, after abortion with retained tissue, for postpartum bleeding due to retained placenta, or to evaluate abnormal uterine bleeding.
Alternatives include watchful waiting or medication (misoprostol) when safe.
Recovery is usually quick: cramping and light-to-moderate bleeding that improves over days, follow-up may include pathology, ultrasound, and/or hCG monitoring.
Complications are uncommon but include heavy bleeding, infection, retained tissue, uterine injury, and rare intrauterine adhesions.
Periods usually return in 4–8 weeks, ovulation can happen earlier.
If you need personalised guidance after a procedure or pregnancy loss, you can download the Heloa app for tailored advice and free child health questionnaires.

Questions Parents Ask

Can you breastfeed after a D&C and anaesthesia?

In most cases, yes—breastfeeding can usually continue after a D&C. Many anaesthetic and pain-relief medicines are compatible with breastfeeding, and the amounts that pass into milk are often very small. To feel reassured, you can mention breastfeeding to the anaesthesia team ahead of time so they can choose the most suitable options. If you feel unusually sleepy, have nausea, or your baby seems more drowsy than usual, a quick check-in with your clinician or midwife can help.

How long will a pregnancy test stay positive after a D&C?

It’s quite normal for a home pregnancy test to remain positive for a while after a D&C, because the hormone hCG can take time to fall. For some parents it fades within days, for others it can take a few weeks—especially if hCG was high. If tests stay strongly positive, symptoms persist, or bleeding doesn’t gradually ease, you can ask about a follow-up blood hCG or ultrasound for peace of mind.

What’s the difference between D&C and D&E?

Both involve dilating the cervix, but they’re usually done at different stages and for different situations. A D&C most often uses suction to remove tissue from the uterus, commonly in early pregnancy loss or to sample the uterine lining. A D&E (dilation and evacuation) is typically performed later in pregnancy and may use additional instruments. Your team can explain which approach fits your medical situation and preferences.

Dilation and curettage (d&c): procedure, risks, and recovery