Dilation and Evacuation (D&E)

Surgery Overview

Dilation and evacuation (D&E) is a type of in-clinic abortion that can be done in the second trimester of pregnancy. It is usually done with vacuum aspiration. Sometimes surgical tools may also be used. Before the procedure, medicines can be given to reduce pain and help you relax.

An ultrasound is done before a D&E to check the number of weeks of the pregnancy. Ultrasound may also be used during the D&E to confirm that all of the tissue has been removed.

A D&E is often done in a clinic. It can also be done in a hospital. The procedure usually takes less than 30 minutes. But you may be in the clinic or hospital for a few hours.

What To Expect

D&E is a medical 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. They help to shrink the uterus back to its nonpregnant size. You may have cramping for up to a few weeks.

After the procedure:

• If your doctor prescribed medicines, take them exactly as directed.
• Rest as much as you can. You can do normal activities the following day, based on how you feel.
• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil). Do not take aspirin unless your doctor prescribed it. Be safe with medicines. Read and follow all instructions on the label.
• Ask your doctor when it is okay for you to have vaginal sex. You can get pregnant in the weeks after an abortion. If you don't want to get pregnant, talk to your doctor about birth control options.

Why It Is Done

D&E is one method available for a second-trimester abortion. It may be done because of a severe medical problem or to remove tissue that remains after a miscarriage. It may also be done if you couldn't get an abortion earlier in pregnancy.

How Well It Works

D&E is an effective method of abortion in the second trimester of pregnancy. It is also an effective way to remove tissue that remains after a miscarriage.

Risks

D&E rarely causes any problems. But the risk of problems is higher for abortions done in the second trimester than for those done in the first trimester. Possible problems include:

• Tissue remaining in the uterus.
• Injury to the cervix.
• A hole in the wall of the uterus (uterine perforation).
• Moderate to severe vaginal bleeding.
• Infection.