Dilatation and evacuation | Surgical Abortion (2024)

FAQs

How much do they dilate your cervix for D&E? ›

The minimum dilation required to pass most forceps used for D&E ranges from 14 to 19 mm, although wider dilation is often required to remove products of conception at advanced gestations [3]. The cervical dilation needed for D&E increases with gestational age.

Risks and complications

These are usually easy to treat and rarely have any long-term health effects. These may require transfer to hospital or surgical procedures, and may have serious long-term health effects. Death is very rarely linked to abortion treatment - less than 1 in 100,000 for all abortions.

The D&E procedure consists of two components: Preparation – Dilation of the cervix with osmotic, pharmacologic, and/or mechanical dilators. Procedure – Evacuation of the uterus with suction, extraction forceps, and curettage.

Most women prefer to take it easy the day after this procedure before returning to normal activities. Some women feel fine right away, while others require more time. Let your body be your guide. No matter how well you are feeling, you should not do heavy exercise for 1 week after your procedure.

“Cervical dilation can be a painful and intense process for many women,” Chuang says. But, again, this will be different for each person dependent on their pain tolerance and other individual factors. “Some women may experience mild discomfort, while others may experience more intense sensations,” she adds.

Usually only a small amount of dilation is needed (less than one half inch in diameter). Tissue lining the uterus will be removed, either with an instrument called a curette or with a suction or vacuum pump. When a suction or vacuum pump is used, the procedure may be called "vacuum aspiration" or "suction curettage."

You may have some bleeding in the first 2 weeks after D&E. Use menstrual pads for the bleeding. Don't use tampons. Don't have sex for at least 1 week.

Dilation and evacuation is the most common and safest means of pregnancy termination during the first and early second trimesters. The major complication is uterine perforation. This can lead to significant sequela including hemorrhage, infection, and embolism.

There were 212 women who had a documented subsequent pregnancy after dilation and evacuation during the study period. The majority (83.5%) had a live birth, whereas 16.5% had another pregnancy loss.

A D&E is done during the second trimester and is pretty similar to a D&C in that it uses a vacuum aspiration, but requires more surgical instruments to remove the tissue (like forceps). Because it's done later on in a pregnancy, it can take a little longer.

What to expect during a D&E? ›

It usually includes a combination of vacuum aspiration, dilation and curettage (D&C), and the use of surgical instruments (such as forceps). An ultrasound is done before a D&E to determine the size of the uterus and the number of weeks of the pregnancy.

An anesthesiologist will give you medicine to help you relax. You will be asleep during the procedure. You will meet with clinic staff to review information about the procedure. You will be given medicine through an IV to help you relax and not feel pain as well as medicine to numb your cervix.

After an early pregnancy loss (1, 2) couples often seek counseling on how long to wait before attempting conception again. Many clinicians recommend waiting at least 3 months (3, 4) with the World Health Organization recommending a minimum of 6 months (5, 6).

Dilation and evacuation (D&E) is the standard surgical technique used for abortion after about 14 weeks. Among midtrimester abortions performed in the United States, about 95% are D&Es.

Adequate cervical preparation before dilation and evacuation (D&E) at 20–24 weeks' gestation reduces procedural risk. For this gestational range, at least one day of cervical preparation with osmotic dilators is recommended before D&E.

The cervix must be 100% effaced and 10 cm dilated before a vagin*l delivery. The first stage of labor and birth occurs when you begin to feel persistent contractions. These contractions become stronger, more regular and more frequent over time.

The active stage of labor can range from a woman dilating anywhere from 0.5 cm per hour up to 0.7 cm per hour. How fast your cervix dilates will also depend on if it's your first baby or not. Mothers who have delivered a baby before tend to move more quickly through labor.

When you arrive, we will evaluate you and your baby to check for labor progression. If you're less than 4 cm dilated: You might be sent home because your labor isn't active enough for hospital admission.