It’s reported that about 10 to 25 percent of pregnancies end in miscarriage, and most of them happen within the first trimester.* Although that number shows how common miscarriages are, a miscarriage is an emotionally and physically difficult time for a woman.
In an ideal scenario, if the miscarriage happens before 10 weeks, women generally miscarry safely on their own, meaning that their body flushes out the pregnancy on its own. This is called complete management. An ultrasound can be done to confirm that the uterus has been cleared.
However, when the body doesn’t miscarry on its own, a doctor may recommend treating the incomplete miscarriage with surgical management. That means gently removing the remains of a pregnancy with the help of a surgical procedure. Surgery may be recommended because it is taking too long for the body to naturally complete the miscarriage; the body doesn’t seem able to complete the miscarriage on its own, indicated by consistent cramping and heavy bleeding; or a woman may choose to have the procedure instead of waiting for the miscarriage to happen on its own to avoid prolonging discomfort or pain.
The most common surgical procedure used to fully remove a pregnancy after an early miscarriage is a D&C. D&C stands for dilation and curettage which basically summarizes and describes the procedure itself. First, the bottom of the cervix or uterus is dilated or widened and then a surgical spoon-like instrument, called a curette, is used to scrape or clean out the lining of the uterus. The procedure is usually done within a few days of the miscarriage, but may need to be expedited if a patient is showing signs of heavy bleeding, risk of infection or has had any medical complications.
As with any surgical procedure, there are a few possible side effects and risks. After a D&C, patients may experience spotting, light bleeding or cramping. These symptoms are usually not a cause to become alarmed. However, call a doctor if there is heavy or prolonged bleeding, fever or severe pain.
What to expect at the Surgery Center of Fort Collins
Here at the Surgery Center of Fort Collins, we understand that this is an emotionally trying time and we expect patients to come in for their procedure feeling a bit nervous. A few days before a scheduled surgery one of our nurses will call to review a patient’s health history, medications being taken, answer any questions the patient might have, confirm arrival time and provide any pre-procedure or surgery instructions. It is important that instructions given are followed in preparation of surgery. Further information on what to expect before the day of a surgery can be found here.
The D&C procedure itself is relatively quick–approximately 15 minutes. It may feel similar to having a pelvic exam done. There is a little discomfort and some cramping in the uterus. As an ambulatory surgery center, Surgery Center of Fort Collins uses a local anesthetic so patients may feel a bit groggy afterwards.
A benefit of a D&C is that tissue removed from the uterus may be sent to a lab for testing. Testing the tissue may help in diagnosing why the miscarriage may have happened in the first place, helping the doctor suggest future care. Having a D&C does not mean a woman cannot have a healthy pregnancy in the future!
Once the procedure is done patients are generally permitted to leave a few hours later. Upon checking out, patients are prescribed an antibiotic as a precaution to prevent any infection. Cramping is a common side effect of the procedure, so patients may also receive a prescription for pain medication. Patients also receive a list of tips on home care or what to do after the procedure with answers to frequently asked questions.
Patients may feel fatigued or feel mild pain or nausea after the procedure. Plans should be made to have a friend or family member drive home and remain with the patient at home for the first 24 hours after the procedure. Visit here to learn more about what to expect after surgery.
D&C recovery time will be dependent upon a patient’s health and routine before their procedure. Most patients are able to return to their usual routines after a few days. However, a doctor should be consulted to find out when it is safe to return to exercise or other physical activity.
Just because the surgery is done does not mean the difficult feelings go away. Although we can estimate how long the physical pain may last, there is no time limit on emotional healing or how long a patient may need to grieve. An inability to sleep, lack of appetite or even the difficulty to focus are normal reactions after a miscarriage. Any patient who may feel she needs emotional support can call our office for references. At the Surgery Center of Fort Collins we are always concerned for our patients’ full, whole well being.