Dilation and curettage is a procedure that a gestational surrogate may find herself having to consider.
Read on to find out more about this procedure, why it may become necessary, and what happens when you choose to have one performed.
What is a D&C
A dilation and curettage is a surgical procedure that serves one of two purposes:
- To diagnose or treat a uterine condition
- To clear out the uterine lining following an abortion or miscarriage. In the case of a miscarriage, this is done to prevent an infection as well as to make room in the uterus for a future pregnancy.
What is the process of a D&C?
The first step in a D&C is for the doctor to dilate (or open) your cervix. He or she would then insert a curette (a surgical instrument that can either be a sharp, scraping tool or a suction tool) to gently remove the tissue from your uterus.
If you are a gestational surrogate and wonder what to expect, keep reading. The dilation and curettage procedure is typically an outpatient one, though you may have to stick around at the hospital for a few hours after it has been performed.
Prior to the procedure, make sure you avoid food and drink. You will also want to be sure that someone will be picking you up from the hospital to take you home as the anesthesia from the procedure will likely render you incapable of driving yourself.
Your doctor may begin the dilating portion of the dilation and curettage procedure procedure several hours to a day beforehand so that your cervix has a chance to open up gradually. This can be done by inserting a medical instrument called a laminaria into your cervix or through medication.
The entire actual dilation and curettage procedure takes about 15 to 30 minutes. The doctor will have you lay back with your legs in stirrups (much as would occur for a pelvic exam) and slowly dilate your cervix using increasingly thicker rods until it is between 6 and 9 millimeters dilated. He or she will then use a curette to remove the tissue. You will be under anesthesia during this procedure (you and your doctor can discuss whether you will be conscious or unconscious) so you should not feel any discomfort.
After the dilation and curettage procedure, and depending on which anesthesia option was used, the gestational surrogate may feel symptoms such as: nausea, vomiting, cramping, and/or spotting/light bleeding. She will be asked to stay at the hospital for a few hours so that the doctor can monitor you for any possible complications. The gestational surrogate will be advised to avoid putting anything into her vaginal area (so no intercourse or tampons) until her cervix is fully back to its normal size to avoid the risk of an infection.
If you are a gestational surrogate who has experienced a miscarriage and chooses to have a dilation and curettage procedure performed, you should speak with your doctor about when you can make another attempt at becoming pregnant.
What happens to the surrogacy arrangement?
When a gestational surrogate has to undergo a dilation and curettage, there are a few things that may take place:
- If the dilation and curettage is due to miscarriage it is common for the surrogacy contract to state that a miscarriage will cause the contract to come to an end. This means that there will be no further obligation on the part of either the intended parents or the gestational surrogate.
- If the gestational surrogate and intended parents would like to attempt another pregnancy after the dilation and curettage, a new agreement (or supplement to the existing agreement) would need to be signed.
- If the dilation and curettage is due to blighted ovum, in most cases, the surrogacy agreement treats a blighted ovum as though no pregnancy resulted from the embryo transfer, so further embryo transfers will be attempted according to the contract.
What advice would you give about dilation and curettage?