D&C: what happens?

A D&C is sometimes needed to clear your womb after miscarriage or birth

A D&C can be performed under a spinal epidural or local epidural but is usually performed under general anaesthetic.  Before the procedure you'll be given a surgical robe to wear rather than any of your own clothes for hygiene reasons. You'll be taken to the operating room - usually on a trolley, which can seem very odd when you don't feel ill  - and then be given your anaesthetic by injection. You might also be given a drug to relax you and stop you producing too much saliva prior to the anaesthetic. The injection of anaesthetic takes near-immediate effect and you will lose consciousness until you are in the recovery room.

Once the anaesthetic has taken effect, your legs will be put up in stirrups so that the  gynaecologist can best access the vagina. The gynaecologist first dilates (opens) the cervix with special instruments and then inserts either a curette, a metal instrument with a loop at one end, a little like a spoon, to gently scrape the womb lining. With an evacuation of retained products (ERPOC) a fine, hollow tube is inserted into the uterus and the pregnancy tissue is cleared with suction. An ERPOC is the method usually preferred after early pregnancy failure. The whole procedure is very quick and you'll be coming round from the anaesthetic within twenty minutes to half-an-hour.

After you come round from the anaesthetic you'll usually be kept in the recovery room for a while where they'll monitor your vital signs until you're properly awake.

How should I prepare for a D&C?

Your anaesthetist and/or gynaecologist will talk you through any preparations you need to make before your D&C. These usually include not eating for at least 6 hours before your admission to the clinic, avoiding drugs and alcohol in the days before surgery, and scheduling or not taking any regular medication you may use.

The day before the operation you may be administered with medication on the cervix to soften it in preparation.

After a D&C - being prepared for the recovery.

What are the risks of a D&C?

D&C is a very safe proceedure but there are several low risks. These include:

• The possibility of uterine perforation - Because the wall of the womb is softer than usual during and immediately after pregnancy, there is a higher, but still very small, chance that the gynaecologist could make a hole in the uterine wall and could result in a haemorrhage
• Asherman's syndrome - This is a very rare complication following a D&C where the scraping leads to the formation of scar tissue which can then expand to fill the uterus and affect your fertility.
• The introduction of instruments into the womb carries a small risk of infection
• There are the usual risks involved with any procedure involving general anaesthetic.