Dilation and evacuation (D&E) is done in
the second 12 weeks (second trimester) of pregnancy. It
usually includes a combination of
dilation and curettage (D&C), and the use of
surgical instruments (such as forceps).
ultrasound is done before a D&E to determine the
size of the uterus and the number of weeks of the pregnancy.
device called a
cervical (osmotic) dilator is often inserted in the
cervix before the procedure to help slowly open (dilate) the cervix.
Dilating the cervix reduces the risk of any injury to the cervix during the
procedure. Misoprostol may also be given several hours before surgery. This
medicine can help soften the cervix.
D&E usually takes 30
minutes. It is usually done in a hospital but does not require an overnight
stay. It can also be done at a clinic where doctors are specially trained to
perform abortion. During a D&E procedure, your doctor will:
The uterine tissue removed during the D&E is examined
to make sure that all of the tissue was removed and the procedure is
Doctors may use ultrasound during the D&E procedure
to confirm that all of the tissue has been removed and the pregnancy has
Dilation and evacuation (D&E) is a
surgical procedure. A normal recovery includes:
Ask your doctor if you can take acetaminophen (such as
Tylenol) or ibuprofen (such as Advil). They may help relieve cramping
pain. Be safe with medicines. Read and follow all instructions on the label.
Call your doctor immediately if you have
any of these symptoms after an abortion:
Call your doctor for an appointment if you have had any of these symptoms after a recent
Dilation and evacuation (D&E) is
one of the methods available for a second-trimester abortion. A D&E is done
to completely remove all of the tissue in the uterus for an abortion in the
second trimester of pregnancy.
Dilation and evacuation may also be used to remove tissue that remains after a miscarriage.
Dilation and evacuation is a safe and
effective method. It has become the standard treatment of care in the United
States for an abortion in the second trimester of pregnancy.
The risks of dilation and evacuation (D&E)
Risks are higher for surgical abortions done in the second
trimester of pregnancy than for those done in the first trimester, particularly
if they are done after 16 weeks of pregnancy.
vacuum aspiration and medicine to stop bleeding are
used to treat retained products of conception or blood clots.
An abortion is unlikely to affect
your fertility, so it is possible to become pregnant in the weeks right after
the procedure. Avoid sexual intercourse until your body has fully recovered,
for at least 1 week or as advised by your doctor. When you do start having
intercourse again, use birth control, and use condoms to prevent
Counseling for a second-trimester abortion may be more
involved than for an early abortion because of the length of the pregnancy and
the reason for the abortion.
Should you have continuing
emotional reactions after an abortion, seek counseling
from a grief counselor or other licensed mental health professional.
Depression can be triggered when pregnancy hormones
change after an abortion. If you have more than 2 weeks of symptoms of
depression, such as fatigue, sleep or appetite change, or feelings of sadness,
emptiness, anxiety, or irritability, see your doctor about treatment.
The hospital or surgery center may send you instructions on how to get
ready for your surgery or a nurse may call you with instructions before your
If you have an abortion in an outpatient center and there is a complication, you may be taken to a hospital.
Right after surgery, you will be taken to a recovery
area where nurses will care for and observe you. You will probably stay in the
recovery area for a period of time and then you will go home. In addition to
any special instructions from your doctor, your nurse will explain information
to help you in your recovery. You will go home with a page of care instructions
including who to contact if a problem arises.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineKathleen Romito, MD - Family MedicineAdam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineSpecialist Medical ReviewerRebecca H. Allen, MD, MPH - Obstetrics and GynecologyKirtly Jones, MD - Obstetrics and Gynecology
Current as ofMarch 16, 2017
Current as of:
March 16, 2017
Sarah Marshall, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Rebecca H. Allen, MD, MPH - Obstetrics and Gynecology & Kirtly Jones, MD - Obstetrics and Gynecology
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Last modified on: 8 September 2017