Whenever medical professionals talk about a dilation and curettage (D&C) procedure, they spend most of their energies talking about the procedure itself. There are some women who likely want to know everything that will be going on during the surgery. For women like me, that information only increased the anxiety and stress.
Here are a few things you will want to know before your D&C (first trimester) or D&E (second trimester):
No. 1: A D&C is not only performed for miscarriages.
It's a procedure used in many other medical issues, including fibroid removal. As a result, you may have a question or two (i.e., "When was your last period?") that stands out as insensitive.
No. 2: Your paperwork will call it an "abortion."
Mentally prepare yourself to read "missed abortion" or "abortion" in the paperwork. If you aren't expecting it, it can take your breath away.
No. 3: You will get to determine what happens to your baby.
You get to choose where the "products of conception" will be given/placed. It feels overwhelmingly formal and insensitive.
That being said, you can take your baby home with you, have it sent to a funeral home, or leave it at the hospital. There is no pressure to do anything. This is a personal decision, and it helps to know that you can make it.
No. 4: The anxiety building up to the procedure is worse than the recovery.
If there is good news, it's that the D&C will be relatively fast and painless. You'll be mentally beat-up, but physically it's easier than other surgeries.
For your vaginal discomfort, I would call it more like feeling chaffed rather than pain. Most doctors will let you stick with Advil and Tylenol during your recovery. There's not necessarily a need for anything stronger. As always, check with your doctor.
No. 5: No bleeding is as common as bleeding.
Following the procedure, you're going to be told to expect heavy, period-like bleeding for a day or two before it fizzles out and to call the hospital if you soak a pad within an hour or so. Basically, call the hospital if it gets super, super heavy or you run a fever. Guess what? They don't tell you what happens if you have little bleeding.
It turns out that having little bleeding is normal as well. There's no playbook here of what to expect since every woman can have a different experience, and that is the worst. When you mentally feel at your worst, it's weird to physically not be dealing with heavy bleeding and cramping.
No. 6: Not all doctors will track your hCG levels.
If you Googled any post D&C questions, you probably ended up in a forum like Baby Center or What To Expect. As you read, you probably saw many women had their hCG levels measured at least twice during the recovery process. Others don't do it at all. Why the difference:
- It can depend if it's your first versus your third miscarriage. First miscarriages are almost treated like a one-off event rather than a sign of an infertility concern.
- Different doctors have different policies. It seems like a catch-all answer, but one doctor's practices may be different.
- Some wait and see. It's not common for any tissue to remain after a D&C, and there are doctors that will take a wait and see approach. Unless you're showing signs of an infection or having excessive bleeding, there's no test.
- If nothing else, ask to be tested. Your doctor can advise you further.
- Use a HPT test. It's heartbreaking to see a positive test, but it can help see where your hCG levels are. Most standard home pregnancy tests (i.e., the one you would pick up from the store), will show you a negative test once your hCG levels drop below 20-50 mIU/hCG (depending on the test).
There's no rush to even talk about trying to conceive again. At your follow-up appointment, your doctor will be able to tell you how long to wait. Most will advise you to wait until your next cycle, meaning you need to wait for your first post-surgery period. Don't take advice from other women on forums instead of your doctor.
Remember that each woman is different? Your doctor may have specific reasons to wait (or not to wait), and s/he is going to be your key here. Please don't assume that since other women say it's delayed by one cycle for dating purposes only, you should go against doctor orders. Stock up on condoms in meantime.
No. 8: Your period will return.
Waiting for your period will be pretty frustrating. By the time you've seen the doctor, you're on the way to emotionally healing. That doesn't mean all is peachy and wonderful, but you're ready for some normal to return to your life. You want to feel again. Then...you wait. And wait.
- How long it takes: They say it can start as early as 2 weeks and as late as 8 weeks. In truth, it's closer to 4-8 weeks. Most doctors will agree that "light periods" 2 weeks after surgery are related more to your hormone levels dropping than it is a period.
- What it'll look like: For most women, the first true period after surgery isn't going to light. It may have spotting leading up to it, but it will be really heavy. In my experience, it was like a dam breaking for two days.
No. 9: Sex will feel weird the first time after surgery.
This is one of those things no one ever talks about. For the first two weeks after surgery, you're instructed to avoid inserting anything vagina - including a penis. It's not that you'll be up to sex again for a while, but when you are, prepare yourself for it to feel weird. It shouldn't be painful (call your doctor if it is), but it won't necessarily feel good either.
It's okay. Your body has gone through major trauma and is recovering. Additionally, you have a mental recovery that is intense. Combined, you have the perfect scenario for sex that's - well - not what you would expect.
