Dilation and curettage (D&C) is a minor surgical procedure performed to remove tissue from the uterus. The procedure involves briefly opening the cervix, the lower part of the uterus, and then using a specialized instrument or suction to clear the uterine lining. A D&C may be performed for diagnostic purposes, such as sampling tissue for abnormal bleeding, or therapeutically following a miscarriage or abortion. Recovery requires a short period of rest and adherence to specific activity limitations.
The Initial 24 to 48 Hours of Rest
The first one to two days following a D&C are dedicated to immediate, passive recovery, primarily due to the effects of anesthesia. Patients receiving general or regional anesthesia will experience grogginess and require a responsible adult to drive them home. For the first 24 hours, avoid activities requiring concentration, such as driving, operating machinery, or making important decisions.
During this initial period, mild cramping, similar to menstrual cramps, and light vaginal bleeding or spotting are normal. Over-the-counter pain relievers, like ibuprofen or acetaminophen, are usually sufficient to manage this discomfort. This passive rest allows the effects of the anesthesia to dissipate and begins the initial phase of uterine healing.
Specific Physical Activity Restrictions
To prevent infection and support uterine healing, specific activities must be restricted for one to two weeks following the procedure. Because the cervix was dilated during surgery, it remains slightly open, creating a pathway for bacteria to enter the uterus. This risk of infection is the primary reason for temporary restrictions.
Avoid inserting anything into the vagina, including tampons, douches, or menstrual cups. Use only external sanitary pads to manage post-procedure bleeding, which also allows for easier monitoring of the flow. Sexual intercourse should be postponed for at least two weeks, or until a healthcare provider confirms the cervix has closed and bleeding has stopped.
Activities involving submerging the body in water must also be avoided for approximately two weeks after the D&C. This includes taking baths, using hot tubs, and swimming. Showering is permitted, but full submersion is restricted because water can introduce bacteria into the vaginal and uterine environment, increasing the risk of infection.
Timeline for Returning to Work and Exercise
The timeline for resuming daily responsibilities and physical activity is individualized, but general guidelines exist based on the type of exertion. Many individuals feel well enough to return to a desk job or sedentary work within one to two days. Returning to work often depends more on managing mild cramping and the dissipation of anesthesia effects than on the procedure itself.
For jobs requiring heavy lifting, prolonged standing, or strenuous physical labor, a longer rest period of one to two weeks may be necessary. This delay prevents excessive strain on the healing uterus and reduces the risk of complications.
The return to exercise follows a similar progression. Light exercise, such as gentle walking or stretching, can typically be resumed a few days after the D&C. However, vigorous or high-impact activities, including running, heavy weightlifting, and intense aerobic classes, should be avoided for a minimum of two weeks. Strenuous activity can cause increased bleeding or cramping, signaling that the body requires more time to recover.
Signs Requiring Immediate Medical Attention
While a D&C is generally safe, it is important to monitor for signs of complications, such as infection or hemorrhage, which require immediate contact with a healthcare provider.
Warning Signs
- A persistent fever of 100.4°F (38°C) or higher, which is a significant indicator of possible infection.
- Chills, which often accompany a fever.
- Heavy bleeding that is not subsiding (soaking through two maxi-pads or more in an hour for two consecutive hours).
- Passing large blood clots.
- Severe abdominal pain not relieved by medication.
- Vaginal discharge that develops a foul odor, which can signal a uterine infection.