D&C means: dilation and curettage, which is a small surgical procedure that is sometimes performed when a pregnancy is no longer viable and miscarriage is imminent.
D&E means: dilation and evacuation, usually refers to a second trimester procedure carried out in a similar way that a D&C, but uses a vacuum tool when a pregnancy is no longer viable, the baby passes away or if necessary after a naturally-completed miscarriage.
Both procedures can be done as an out-patient with a general anesthesia or local, depending on your doctor’s set-up and the specifics of your particular situation. It’s not always recommended to have this procedure after a miscarriage — the early you were in your pregnancy, the less likely you are to need the procedure, but some women do prefer to have one in place of waiting for a miscarriage to naturally happen.
According to the American Pregnancy Association, if your pregnancy is over 10 weeks, there is a higher chance of having an incomplete miscarriage and a D&C may be recommended. The main concern is hemorrhage and infection as well as the emotional health of the mother. It’s best to talk with your doctor about your options and feelings and together, determine what you feel is the best course.
As with any medical procedure, there are some risks which include:
- complications with anesthesia
- heavy bleeding or hemorrhage
- scarring of the uterus or cervix
- infection
- perforation of the uterus
- incomplete procedure
What to expect:
You can expect a little pain and cramping for about 24 hours after the procedure. You should take care to rest and not over-strain yourself during the first day. These light cramps can usually be managed with Ibuprofen and should be expected to go away within a few days to 2 weeks. It’s recommended to avoid tampons and intercourse for 2-6 weeks and you should schedule a follow-up exam with your doctor in about 4-6 weeks.
Real advice:
While D&C is not always needed when miscarriage happens, many have been through the procedure. We asked the Unspoken Grief community on Facebook what their real advice is for someone who may be facing a D&C — what to expect and what helped. Here’s what they had to say:
Well, the physical recover is easy, but the emotional recovery take a lot of time. We need family and friends support. Talk with a group related to Miscarriages. Read books, look for advice etc. — Karol
My d&c was 2 weeks after an incomplete miscarriage, so I was actually grateful to have it because I was still so sick (body still thought I was pregnant). The procedure itself wasn’t bad, but I was completely asleep. I agree with the Karol…it’s the emotional recovery that will take a lot more time. And you just have to allow yourself to take that time to heal. — Teri
The emotional recovery is tougher than the physical. I think mine was even worse because while my husband and my mother were really supportive, the rest of our family pretended like it didn’t happen. I also didn’t think I’d be so bitter about other pregnancies/new babies all around. Also, don’t discount your spouse’s/partner’s feelings…realizing someone else was hurting with me helped, too (that sounds terrible, but it was a comfort to know I wasn’t alone). It was his baby, too. Overall, just find support! — Courtney
Make the doctor/nurse write down any instructions for aftercare. You aren’t in your right mind before or after, and you might not remember. Also, the procedure is quick and easy, it’s the waiting to get it done and the emotional toll it takes after that’s hard. — Anna
Take the meds the doctor offers. Cancel everything on the calendar that week. Have a good heating pad and a pile of books/movies, etc that have NOTHING to do with children. Cry. Grieve. Eat, drink lots of water, take vitamins. Pamper yourself. Once you’re up and about take walks to gain strength and reflect. — Claire
My only advice is that you need to do whatever YOU need to do. I stayed in bed for days… physically it isn’t too bad but emotionally it is horrific — Jenny
Mine was optional, for missed miscarriage. (no heartbeat & measured 6 weeks behind, but no symptoms such as spotting or cramping). For my situation, I chose D&C out of fear, not knowing what to expect if I waited it out. In retrospect, I wish I had waited. — Sarah
Most people have no pain and bleed a few days, I had no immediate pain but the next 16 days had HEAVY bleeding with clots and some of the most painful cramps I had ever had and I used to have Darvocet ? and be on bedrest for cramps. Again most people NO PAIN and Little bleeding. I wish I would have known the physical on top of the emotional was doubly hard to bear. Since then I have had people say MOST doesn’t mean ALL people, but at the time I felt blindsided. I hemorrhaged after delivering at home 5/29 and still am starting and stopping bleeding or spotting. I am praying that I don’t have to go through it again and will see the doctor Monday. I was reminded that this time might not have ANY problems, but I felt deceived and unprepared and wished someone would have told me first.