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.