At some point in her life, a woman may be advised to have a dilation and curettage, commonly called a D&C. Hearing that you need a surgical procedure can feel overwhelming, so understanding what it involves—and why it’s recommended—can help ease anxiety and support informed decision‑making.
What Is a Dilation and Curettage?
A dilation and curettage (D&C) is a minor surgical procedure performed by an obstetrician‑gynaecologist. During the procedure, the cervix (the opening or “neck” of the womb) is gently widened to allow instruments to enter the uterus. Tissue inside the uterus is then removed, either to diagnose a condition or to treat a medical problem. There are different techniques used for D&C, including sharp curettage, suction curettage, and vacuum aspiration. The method chosen depends on the reason for the procedure and the woman’s individual circumstances.
Why Might a Woman Need a D&C?
A D&C may be recommended for several common gynaecological or pregnancy‑related conditions, including:
- Miscarriage or abortion
- Thickening of the uterine lining (endometrium)
- Endometrial polyps
- Heavy menstrual bleeding that does not improve with medication
- Abnormal bleeding after menopause
- Removal of a misplaced intrauterine contraceptive device (IUCD or IUS)
D&C After Pregnancy Loss
One of the most common reasons for a D&C is pregnancy loss. In these situations, the procedure is used to remove pregnancy tissue—such as the foetus, placenta, or membranes—from the uterus. While many miscarriages can be managed with medications that help the uterus expel the tissue naturally, some women still require a D&C. The procedure offers a faster resolution and may be preferable for women who want the process completed promptly. In many cases, the cervix is already partially open, reducing the need for further dilation. Women diagnosed with a molar pregnancy also require a D&C. In these cases, suction curettage is preferred to ensure complete removal of abnormal tissue while reducing the risk of spread to other parts of the body.
D&C in the Postpartum Period
After childbirth, small pieces of placenta, membranes, or large blood clots can sometimes remain inside the uterus. This condition—known as retained products of conception—is a common cause of heavy bleeding after delivery. A D&C may be required to remove this tissue and control bleeding. In postpartum women, the cervix is usually already open, so additional dilation is rarely necessary.
D&C for Thickened Endometrium or Polyps
A thickened uterine lining seen on ultrasound may be caused by endometrial polyps or other conditions such as endometrial hyperplasia. A D&C allows removal of this tissue, which is then sent to a laboratory for microscopic examination. This testing helps confirm the diagnosis and guides future treatment and follow‑up. It’s important to know that polyps and abnormal thickening can recur, and some women may need repeat procedures.
D&C for Heavy Menstrual Bleeding
For some women, heavy menstrual bleeding (HMB) does not improve despite treatment with medications such as tranexamic acid, anti‑inflammatory drugs, or hormonal therapies. In these cases, a D&C can be used as a temporary measure to reduce bleeding while longer‑term management is planned.
Preparing the Cervix
In certain situations, medications may be given before the procedure to soften the cervix and make dilation easier and safer.
Risks of a D&C
Like all surgical procedures, a D&C carries some risks. Your doctor should discuss these with you and obtain your informed consent beforehand. Possible risks include pain, infection, bleeding, injury to the uterus or cervix, formation of scar tissue inside the uterus (Asherman syndrome), and complications related to anaesthesia. Although some risks are serious, they are generally uncommon, and the procedure has a good safety record when appropriately indicated.
Anaesthesia Options
A D&C is usually performed in a procedure room or minor operating theatre. Depending on your situation, it may be done under local anaesthesia with sedation, regional anaesthesia (such as a spinal block), or general anaesthesia. Your anaesthesiologist will assess you beforehand to determine the safest option.
Final Thoughts
A dilation and curettage is a common and important procedure used to diagnose and treat a variety of gynaecological and pregnancy‑related conditions. While the idea of surgery can be frightening, understanding why it’s recommended and what to expect can help you feel more prepared and empowered. When medically indicated, a D&C is generally safe and effective.
Disclaimer: This information supports education only and does not replace advice from your doctor.
Faith Reflection: Your health matters. Seeking care is an act of wisdom and stewardship. You are not alone.
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