Dilation and Evacuation (D&E)
Surgery Overview
Dilation and evacuation (D&E) is done in the second 12 weeks (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration and the use of surgical tools (such as forceps).
An ultrasound is done before a D&E to find out the size of the uterus and the number of weeks of the pregnancy.
D&E usually takes less than 30 minutes. It can be done in a hospital but does not require an overnight stay. It can also be done at a clinic where doctors are specially trained to perform abortion.
The uterine tissue removed during the D&E is examined to make sure that all of the tissue was removed and the procedure is complete.
Doctors may use ultrasound during the D&E to confirm that all of the tissue has been removed and the pregnancy has ended.
What To Expect
Dilation and evacuation (D&E) is a surgical procedure. A normal recovery includes:
- Irregular bleeding or spotting for the first 2 weeks. Use sanitary pads until you stop bleeding. Using pads makes it easier to monitor your bleeding.
- Cramps similar to menstrual cramps. These may last from several hours to a few days, as the uterus shrinks back to its nonpregnant size.
After the procedure
- Rest quietly that day. You can do normal activities the following day, based on how you feel.
- Acetaminophen (such as Tylenol) or ibuprofen (such as Advil) can help relieve cramping pain. Be safe with medicines. Read and follow all instructions on the label.
- Medicines may be given to help the uterus contract and return to its prepregnancy size.
- Ask your doctor when it is okay for you to have sex.
- If you don't want to get pregnant, use birth control when you start having sex again.
Why It Is Done
Dilation and evacuation (D&E) is one of the methods available for a second-trimester abortion.
- A D&E is sometimes offered to women diagnosed in the second trimester with a fetus that has severe medical problems or abnormalities.
- A woman may not realize that she is pregnant until the second trimester. When this happens, a D&E may be necessary for abortion.
- A woman who doesn't have access to an abortion earlier in her pregnancy may need to have a D&E.
Dilation and evacuation may also be used to remove tissue that remains after a miscarriage.
How Well It Works
Dilation and evacuation is a safe and effective method for an abortion in the second trimester of pregnancy. D&E may also be used to remove tissue that remains after a miscarriage.
Risks
The risk of problems from dilation and evacuation (D&E) is rare. But some problems may include:
- Tissue remaining in the uterus (retained products of conception).
- Injury to the cervix.
- A hole in the wall of the uterus (uterine perforation).
- Moderate to severe vaginal bleeding.
- Infection.
Risks are higher for surgical abortions done in the second trimester of pregnancy than for those done in the first trimester.
Credits
Current as of: November 22, 2021
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Rebecca H. Allen MD, MPH - Obstetrics and Gynecology & Kirtly Jones MD - Obstetrics and Gynecology
Current as of: November 22, 2021
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & E. Gregory Thompson MD - Internal Medicine & Rebecca H. Allen MD, MPH - Obstetrics and Gynecology & Kirtly Jones MD - Obstetrics and Gynecology