If you miscarry or have an otherwise abnormal pregnancy, your doctor may recommend a dilation and curettage (D&C) procedure (as opposed to a natural miscarriage). A D&C can be a first-line treatment option for clearing the uterus or for instances where your body does not expel all tissue on its own. In this case, the procedure is necessary to stop bleeding and prevent hemorrhage. Like any surgical procedure, however, a D&C carries some risks. As a surrogate, it's essential that you understand the risks and benefits of this option.

 

WHAT IS A D&C PROCEDURE?

A D&C procedure usually takes just 10 to 15 minutes, but you may stay at the clinic or medical site for up to 5 hours. During the procedure, you’ll either be sedated using either a general anesthetic or given an epidural or local anesthetic. Your cervix will be dilated to allow a scalpel or vacuum into the uterus to remove tissue associated with pregnancy. This outpatient surgical procedure is generally routine and free of complications. However, as with all medical procedures, there can be risks. 

WHAT ARE COMMON D&C RISKS & COMPLICATIONS?

The most common complication of a D&C, according to the Mayo Clinic, is the perforation of the uterus. In this instance, a cutting object would inadvertently poke a hole in the wall of the uterus during the clearing of the pregnancy tissue. These perforations will usually heal on their own and only represent real concern if a blood vessel or secondary organ is damaged. 

Other potential D&C complications include:

• Damage to the cervix: It is possible for the cervix to be torn during the procedure. If this were to happen, your doctor would apply pressure to the cervix and then use stitches to repair the tear.

• Scar tissue or adhesions inside of the uterus: Known as Asherman’s syndrome, the development of scar tissue in the uterus happens in roughly 30 percent of D&C patients. This condition, which becomes more likely with each subsequent D&C, can lead to painful, absent or otherwise abnormal menstrual cycles. Additionally, it can lead to difficulty with future fertility, occasionally resulting in increased miscarriages or total infertility.

• Infection: While incredibly rare, infection can occur following the procedure. Infections are often detected by a fever or odorous vaginal discharge.

WHAT TO DO DURING D&C RECOVERY

You’ll want to pay close attention to your body after the D&C to ensure that you’re healing properly. You can usually return to your regular activities after a few days, but you may experience mild cramping and light spotting. You should wear a sanitary pad and take pain relievers if necessary. 

Your next menstrual cycle also might come early or late after the procedure. Be sure to call your doctor right away if you experience any of the following symptoms:

• Heavy bleeding

• Bleeding lasting longer than 2 weeks

• Fever

• Cramping lasting more than 48 hours

• Foul smelling discharge

• Pain that gets worse as the days progress

At Growing Generations, we understand that a miscarriage is a challenging and emotional event for both surrogates and the intended parents. We're here to support you through this difficult time. Reach out to us online at any time.