A D&C (dilation and curettage) is not automatically an abortion. It is a surgical procedure used for several different medical reasons, only one of which is ending a pregnancy. Most commonly, a D&C is performed to manage a miscarriage, diagnose abnormal uterine bleeding, or remove uterine polyps. The same procedure can also be used for an elective abortion, but the technique itself is medically neutral: it’s a tool, not a diagnosis.
What a D&C Actually Is
“Dilation” refers to gently opening the cervix. “Curettage” refers to removing tissue from inside the uterus, either with a scraping instrument called a curette or with suction. The procedure is typically done under sedation, takes a relatively short time, and is considered routine. A local anesthetic is injected near the cervix to reduce pain, and the patient is usually able to go home the same day.
The tissue removed during a D&C can serve completely different purposes depending on the situation. It might be pregnancy tissue that the body hasn’t expelled after a miscarriage. It might be a sample of the uterine lining sent to a lab to check for cancer or other abnormalities. Or it might be tissue removed during an elective pregnancy termination. The physical steps of the procedure look largely the same regardless of the reason.
Why the Confusion Exists
In medical terminology, the word “abortion” covers more than most people realize. Doctors use “spontaneous abortion” to mean a miscarriage, a pregnancy that ends on its own. “Induced abortion” refers to an intentional termination. Both are classified under the umbrella of “abortion” in medical records and billing codes, even though they describe very different situations. The medical coding system used across the U.S. healthcare system maintains entirely separate categories for spontaneous abortion and induced termination of pregnancy, with distinct codes for each.
This clinical language is one reason the confusion persists. A patient who has a D&C after a miscarriage may see the word “abortion” on paperwork and panic, not realizing it’s the standard medical term for any pregnancy that doesn’t continue. A D&C performed to complete a miscarriage and a D&C performed to end a viable pregnancy use the same surgical technique but are coded, classified, and understood differently in medicine.
Common Reasons for a D&C
The American College of Obstetricians and Gynecologists identifies surgical evacuation (which includes D&C) as one of three accepted treatment options for early pregnancy loss. The other two are expectant management, which means waiting for the body to pass the tissue naturally, and medical treatment with medication. All three approaches are considered effective, and patients are typically offered a choice among them.
A D&C after miscarriage is often recommended when the body hasn’t fully expelled pregnancy tissue on its own, which can cause prolonged bleeding or raise the risk of infection. It’s also used when a pregnancy has stopped developing but the body hasn’t yet recognized the loss, sometimes called a missed miscarriage.
Outside of pregnancy entirely, a D&C is a diagnostic tool. When someone has heavy or irregular periods, unexplained uterine bleeding, or bleeding after menopause, a D&C allows a doctor to collect tissue from the uterine lining and examine it for conditions like polyps, hormonal imbalances, hyperplasia (thickening of the lining), or uterine cancer. In these cases, the procedure has nothing to do with pregnancy at all.
When a D&C Is an Abortion
A D&C is an abortion when it is used specifically to end a viable pregnancy. In the first trimester, suction curettage (a D&C performed primarily with vacuum aspiration) is one of the most common methods used for elective pregnancy termination. The steps are mechanically similar to a D&C for miscarriage: the cervix is dilated and the uterine contents are removed. What differs is the clinical context and the intent.
This distinction matters in practical terms. In states with abortion restrictions, the reason for a D&C can affect whether the procedure is legally permitted, how it’s coded in medical records, and whether insurance covers it. A D&C for miscarriage management is standard medical care that is not subject to abortion restrictions. A D&C for elective termination falls under whatever abortion laws apply in that state. The procedure is the same; the legal and billing classification depends on why it’s being done.
What the Procedure Feels Like
Most patients receive IV sedation, so they’re relaxed or lightly asleep during the procedure. A speculum is placed to visualize the cervix, a local numbing agent is injected, and the cervix is gradually widened using a series of small dilators. Then tissue is removed using suction, a curette, or both. The entire process is typically brief.
Afterward, you can expect some cramping and light bleeding, similar to a period. Most people return to normal activities within a day or two, though some spotting can continue for a couple of weeks. You’ll generally be advised to avoid inserting anything into the vagina (tampons, for example) for a period of time to reduce infection risk.
Risks and Complications
A D&C is considered a safe, routine procedure. Complications are rare but can include uterine perforation (when a surgical instrument creates a small tear in the uterus), infection, or excessive bleeding. Perforation is more likely in people who were recently pregnant or who have gone through menopause, when the uterine wall tends to be thinner or softer.
In rare cases following a D&C for miscarriage, scar tissue can form inside the uterus, a condition called Asherman’s syndrome. These adhesions can affect future periods and fertility, but the condition is uncommon and treatable when it does occur.
The Short Answer
A D&C is a procedure, not a diagnosis. It can be used as part of an abortion, but it can just as easily be used to treat a miscarriage, investigate abnormal bleeding, or remove polyps. Saying “a D&C is an abortion” is like saying “surgery is cancer treatment.” Sometimes it is. Often it isn’t. The reason for the procedure is what defines it, not the technique itself.