Healing After loss: Rebuilding Uterine Health Post- D&C

Losing a pregnancy is a kind of heartbreak that lingers. It’s not just the loss itself but the way it echoes—through conversations that sting, dates that haunt, and moments that catch you off guard. During one of my own losses—a missed miscarriage, also known as a chemical pregnancy—I was given a choice that felt unbearably cruel. I could either wait for my body to recognise the loss, which could take weeks, or opt for a D&C procedure and move forward. Exhausted, devastated, and still feeling incredibly sick with morning sickness and fatigue, I couldn't bear to walk around another second feeling pregnant but carrying no baby inside. So, I chose surgery.

While my rational mind knew that the baby was gone and I had my "clean slate," I held on to that trauma much longer than I'd ever like to admit. Looking back, knowing what I do now, would I have made the same decision? Probably not. But I also don’t regret it, and I refuse to shame other women for making this choice. Instead, I want to talk about what truly happens to our bodies during and after this procedure—and how we can help them heal, both physically and emotionally.

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The Impact of D&C Procedures on Uterine Health

Dilation and curettage (D&C) is often recommended following miscarriage to clear the uterine lining. While it can offer closure during an unimaginably painful time, it’s crucial to understand that D&C is not without risks—especially when performed multiple times.

Recurrent D&Cs can lead to:

1. Intrauterine Adhesions (Asherman’s Syndrome):

   • Repeated scraping can cause scar tissue to form inside the uterine cavity, blocking menstrual flow, causing pain, and preventing implantation.

2. Endometrial Thinning:

   • The endometrium—the lining essential for implantation—is scraped during D&C. Multiple procedures can progressively thin this lining, making it difficult to sustain early pregnancy.

3. Cervical Insufficiency:

   • Repeated dilation can weaken the cervix, increasing the risk of second-trimester pregnancy loss or preterm birth.

4. Placental Abnormalities:

   • Scarring can disrupt proper placental implantation, leading to complications like placenta previa and postpartum hemorrhage.

Making More Conscious Decisions About D&Cs

Given these risks, it’s vital to approach D&C procedures with more information and intention. Understanding the long-term impacts—such as endometrial thinning, intrauterine adhesions, and hormonal imbalances—can help women weigh their options more consciously. Exploring alternatives like expectant management (allowing the body to pass tissue naturally) or medical management (using medication to support the process) might also be viable paths to consider.

Goals for Healing Post-D&C

Reducing Inflammation and Preventing Adhesions:

• Curcumin and Omega-3s: Anti-inflammatory supplements that help minimise scarring and support tissue repair.

• Bromelain: An enzyme that aids in breaking down fibrin, reducing the risk of adhesions.

• Quercetin (500mg/day): Reduces histamine and inflammation, supporting a healthy uterine environment.

• N-Acetyl Cysteine (NAC) (600-1200mg/day): Supports glutathione production, acts as an antioxidant, and helps prevent fibrosis and scarring.

Promoting Endometrial Regeneration:

• Vitamin E (400-800 IU/day): Supports endometrial thickness.

• L-Arginine (3-6g/day): Enhances uterine blood flow.

• Phytoestrogens (Red Clover, Flaxseed): Promote healthy oestrogen metabolism.

• Shatavari (Asparagus racemosus): A uterine tonic that supports endometrial health.

Supporting Hormonal Balance:

• Vitex (Chaste Tree Berry): Regulates progesterone.

• Ashwagandha: Supports adrenal health and hormonal balance.

• Maca Root: Enhances overall endocrine function and supports ovulatory cycles.

Improving Uterine Blood Flow:

• Castor Oil Packs: Applied to the lower abdomen to enhance circulation.

• Acupuncture: Improves blood flow and reduces inflammation.

• Cinnamon (Cinnamomum verum): Supports blood flow and may reduce uterine cramping.

Emotional and Nervous System Support:

• Magnesium Glycinate: Calms the nervous system.

• Skullcap and Lemon Balm: Herbal nervines that reduce anxiety.

• Kinesiology and Therapy: Address the emotional trauma of loss, helping to release stored grief and balance the nervous system.

Rethinking Post-Miscarriage Care

Our healthcare system often treats miscarriage as a temporary setback rather than a profound loss that demands both physical and emotional recovery. A more holistic approach would include informed consent, integrated care plans, and long-term uterine health monitoring.

If you've ever felt unsupported in navigating the aftermath of pregnancy loss, you're not alone.

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DISCLAIMER

This content is not intended as medical advice and should not be used to diagnose, treat or prevent any disease or health illness. Please consult a qualified healthcare professional before acting on any information presented here.

Further reading:

Davar, R., Firouzabadi, R. D., & Ara, K. C. (2013). Dilatation and Curettage Effect on the Endometrial Thickness. Iranian Red Crescent Medical Journal, 15(4), 350. https://doi.org/10.5812/ircmj.9863

Lohmann-Bigelow, J., Longo, S. A., & Jiang, X. Does Dilation and Curettage Affect Future Pregnancy Outcomes? The Ochsner Journal, 7(4), 173. https://pmc.ncbi.nlm.nih.gov/articles/PMC3096409/

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