Surgical management of miscarriage

Surgical management of a miscarriage is a choice for all women who have had a miscarriage. It may also be recommended or necessary depending on the circumstances, for example if there is unusually heavy bleeding.


What surgical management of miscarriage is

Surgical management is the evacuation of the uterus (womb) — a surgical procedure to remove the pregnancy tissue from the uterus. It is done using a suction device placed through the vagina and cervix into your uterus. It is also known as a D&C (dilatation and curettage).

The procedure can be done under general anaesthesia or sedatives. It takes around 3 to 5 hours. 

An evacuation of the uterus for miscarriage:

  • is a choice for all women
  • may be necessary if there is unusually heavy vaginal bleeding
  • can be recommended by the medical team based on individual circumstances. 

Preparing for the procedure

  • Your appointment will be arranged by the early pregnancy assessment unit.
  • You must not eat for 6 hours before the procedure. You may drink sips of water up to 2 hours before your arrival time.
  • Have a shower on the morning of the procedure.
  • Do not wear makeup, nail polish or jewellery.
  • You cannot drive for 24 hours after having an anaesthetic. Arrange to get to the hospital and for someone to drive you home afterwards. 

On arrival

A nurse will check you in and make sure you are ready. They will ask you what you would like done with your pregnancy
tissue. 

Care of your pregnancy tissue (internal link)

You will usually be given some pain relief medicine and a medicine called misoprostol while you wait. 

The surgeon and the anaesthetist will see you to explain the procedure and get your consent. This is a good chance to ask any questions. Once the team is ready, you will be taken through to theatre. The pregnancy tissue will be removed using a suction device. You will not feel anything while you are asleep.


After the procedure

Once the procedure is complete, you will be moved to the recovery room where you are monitored as you wake up from the anaesthetic. A nurse will be with you the whole time to make sure you are comfortable. They can give you pain relief and anti-nausea medicines (if you feel sick).

When you are awake and feel well again, the nurse will help you out of bed, get dressed and give you something light to eat and drink.

You should not drive for 24 hours after the anaesthetic. Arrange to be driven home and for an adult to be with you for the 24 hours after the procedure.

Before you leave you will be given a clinical summary letter about your procedure and a copy will be sent to your healthcare provider. We recommend you have the following day off work and see your healthcare provider for a check up in 2 weeks. 

This could be a difficult time for you. You may wish to talk with someone about the strong emotions you are experiencing — these can be common feelings at this time. Ask the staff if you can contact the social work and counselling services for your area. They will be happy to talk with you.

Where to get help after the loss of a pregnancy or child

If you need support or advice, get in touch with a bereavement service or talk to your midwife or healthcare provider. Other support services are also available.

Information for family and whānau experiencing the death of a baby or child — Whetūrangitia (external link)