Dilation and evacuation (D&E) is done in the second 12 weeks (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration, dilation and curettage (D&C), and the use of surgical instruments (such as forceps).

An ultrasound is done before a D&E to determine the size of the uterus and the number of weeks of the pregnancy.

A 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.