I’m deeply sorry if you’re clicking on this post because you’ve had a miscarriage. I truly am. I hope you feel my compassion reaching out to you through your screen.
As you go through your decisions or next steps with your D&C, these are some common questions and answers and what my experience was having one performed on me.
What is a D&C?
It stands for Dilation and Curettage but it’s usually called by its abbreviation. A D&C is minor surgery to remove tissue from the lining of the uterus, usually using a spoon-shaped tool called a curette. There are other reasons for a D&C include diagnosing and/or treating other endometrial issues like fibroids or polyps.
Should I choose a D&C to manage my miscarriage?
Your physician will give advice about what approach to take for your loss, such as ‘wait and see’ (expectant management) a D&C (a surgical treatment) or misoprostol and/or mifepristone (medical treatment). For example, you might be told a D&C is your only option after medical treatment failed.
If it is your choice then you’ll weigh the slight risk of scarring and with any surgery versus at home approach with this particular trauma of passing the blood and tissue. There could be scarring after and it is a slight risk that could impact your future fertility. Luckily scarring can usually be fixed once it’s discovered, but speak with your doctor. It’s a personal decision. Some people prefer to stay home if they can and not have to enter a medical facility. Others want out of sight, out of mind.
Access to a D&C may be another consideration if you’re too far away from a clinic or hospital. You might also have to wait longer than you’d like. Most people want it completed ASAP so any waiting is agony, but unfortunately sometimes there are surgery waits.
Either way, it’s an awful position to be in and it’s one of those times where you don’t want any of the choices, you want to stay pregnant. Again, I’m so incredibly sorry.
Is a D&C one of the most frequent surgeries performed?
Yes, the D&C is a common surgery in many countries. That might give you some peace of mind. A surgeon’s skill is improved the more they perform a specific surgery, so you can probably expect that your surgeon is skilled at a D&C.
What are the anesthesia options?
You may or may not be given a choice to be completely under with general anaesthetic or numbed from around your belly downward with a spinal or epidural or more commonly you’ll be given twilight sedation where you’re given oral medication like Benzodiazepines and/or intravenous medication. Whether you want to be awake or be put under, each come with their own risks and you’ll discuss that with your physicians. When I had my D&C I had a spinal. I shut my eyes throughout and thought of pleasant memories.
Is testing the tissue an option?
Talk to your doctor in advance about testing the baby/fetus tissue for chromosomal issues. If you’re eligible to get testing done then it might give you peace of mind to know those results. Consider what you’d feel in either scenario whether there is a chromosomal abnormality found or not. It’s a consideration and often people after for this or it’s medically indicated after 2 consecutive miscarriages but you could have that conversation with your doctors if this is your first (and hopefully last loss).
What can I expect before and after the D&C?
I had my D&C done in a hospital operating room. Yours could too or it could be in a clinic. They will probably ask you a series of questions including your weight. I had to put a hospital gown on and then lied down with me legs up in stirrups. An obstetrician performed the minor surgery but the anesthesiologist was there to give me my spinal. She first put some numbing medication on my lower back and it worked like a charm – I couldn’t feel the poke at all, however others do.
Then the anesthesiologist tested how much I could feel below my belly by poking my legs a bit while the medication slowly made its way through my body. Once I couldn’t feel much at all, it began. If you’re having general anesthesia then you’ll probably need to fast beforehand and right before you’ll have an IV put in your hand. Then the medication gets added and it’s ‘lights out’ until it’s over.
Most people feel little to no physical pain after but with the emotional pain some people can present differently. Stress like this can have an affect on your body. You also might have cramping for a week or 2 afterwards and bleeding for a couple of days but of course you’ll hear what to expect from your doctor. They’ll probably tell you not to use tampons, have intercourse of any kind or douche for 2 or more weeks after the procedure. A lot of people need rest after but get back to work a day or 2 later but that doesn’t include what you might need for your emotional recovery. I used a heating pad on my stomach after and that felt good. Talk to your doctor.
For some people the initial bleeding can stop and then start again. It’s a nuisance but talk to your doctor about it, as well.
How should I grieve this loss?
Everybody grieves differently. Take all the time you need to process your emotions. Please consider seeing a professional such a therapist or coach if you haven’t already. If you’re having a D&C because of a miscarriage, honour your loved baby and of course yourself however feels right to you. There’s not one way to process nor only one way to decide what to do next including when to try again to get pregnant or what that will look like.
If you’d like some facts and guidance on pregnancy loss check out this podcast Baby or Bust and this one on 5 steps to take after a miscarriage. Each are hosted by fertility physicians.
Consider accepting my compassion I’m sending you.
*This is not medical advice, this is information sharing. Please consult your physician for medical advice.