Opting for a Medical Termination of Pregnancy and a Dilation & Curettage (D&C)

A baby isn’t always planned. And while the news of one can spark a range of happy emotions in most couples, for some, it can be an unnerving surprise. Couples that aren’t ready for a baby can opt for a Medical Termination of Pregnancy (MTP), a procedure that can abort any pregnancy at less than twenty weeks. An MTP works by opening the cervix (the mouth of the uterus) to evacuate the uterus using a suction.

An MTP is usually followed by a Dilatation and Curettage (D&C). A D&C is a procedure that involves the use of a surgical instrument to clean the uterine lining and is performed in an operation theatre after administering short general anaesthesia.

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A D&C takes about ten minutes and includes the following:

1. Before the D&C begins, the legs are placed in stirrups and the doctor places a speculum into the vagina and clamps the cervix in place. Then, the cervix is cleanedwith an antiseptic serum.

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2. A D&C, as its name suggests, contains two steps:

  • Dilatation: The cervix is gradually widened using progressively larger dilators (these are blunt-tipped metal rods – they only sound frightening – they’re not).
  • Curettage: A slender spatula, called a curette, is used to clean the uterine lining. After the wall has been cleaned, the doctor may also use a cannula to suction any particles of the embryo or blood clots that have been left behind.

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3. After a D&C, it’s natural to feel drowsy from anaesthesia. You’re likely to experience light spotting and cramping for the next few days. It is recommended that you hold off on sex and the use of tampons until your doctor gives you a go-ahead. This way, you can ward off bacteria and infections until your body has rebuilt its immunity.

An MTP and D&C can carry several risks, though their occurrence is rare:

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  • Leftover Bacteria: The vagina holds a range of bacteria. During the procedure, these bacteria could travel up to the uterus and the fallopian tubes, and cause damage, blockages and infections.

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  • Scraping of the Uterine Wall: There is a risk that the uterine wall can be scraped too much or too little. If the uterus is scraped too little for fear of damaging the uterine wall, remnants of the embryo will remain in the uterus. In such a situation, a second D&C is recommended. A delayed D&C could mean severe bleeding for several days, as well as discomfort and increased susceptibility to infections.

  • Asherman’s Syndrome: If the uterine wall is scraped too much, its lining could be damaged and could clump together, leading to infertility. In most cases, this condition can be treated. However, if permanent damage occurs during the uterus scraping, infertility could be permanent.
  • Uterus Perforation: During an MTP, perforation of the uterus is common. In most cases, the perforation heals on its own.

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In fact, recovery time after an MTP usually lasts no longer than 48 hours. After the procedure, it’s normal for a woman to bleed for up to ten days. Anything longer than this is a cause for concern and should be brought to the notice of a doctor.

After an MTP and D&C, it’s likely that your menstrual cycle will take on a new timing. But other than that, you should feel healthy and fit within two days of the procedure. If you have recently conceived and feel like you aren’t quite ready to start a family,

visit an obstetrician at Cloudnine to find out more about how an MTP can help you. Start a family when you’re ready. Until then, count on us to help.

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Frequently Asked Questions

Is D&C a painful procedure?

D&C is performed in an operating theatre after administering a short general anaesthesia. After D&C, patients naturally feel drowsy from anaesthesia and experience light spotting and cramping for a few days.

What is a D&C for pregnancy termination?

D&C (Dilatation and Curettage) is a procedure involving the use of surgical instruments to clean the uterine lining, performed in an operating theatre under short general anaesthesia. It's usually performed following Medical Termination of Pregnancy (MTP). The procedure has two steps: dilation (opening the cervix) and curettage (cleaning the uterine lining).

What is the difference between a D&C and a termination of pregnancy?

Medical Termination of Pregnancy (MTP) aborts pregnancies less than 20 weeks by opening the cervix to evacuate the uterus using suction. D&C (Dilatation and Curettage) is a follow-up procedure usually performed after MTP that uses surgical instruments to clean the uterine lining under general anaesthesia in an operating theatre.

How long will I bleed after D&C?

After D&C, it's normal to experience light spotting and cramping for the next few days. Normal bleeding lasts up to ten days after the procedure. Anything longer than ten days is a cause for concern and should be brought to the doctor's notice immediately for proper evaluation and treatment.

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