Cervical Cerclage: Purpose, Procedure, Recovery and Risks
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 31, 2026 · How we review
Quick Answer: What is cervical cerclage?
Cervical cerclage is a procedure in which a healthcare provider stitches the cervix closed during pregnancy to help prevent premature birth from a weakened cervix. It is usually done at about 12 to 14 weeks under local numbing, and the stitch is removed around week 37. Fever, contractions or leaking fluid afterward mean calling your provider right away. [1]
What the research says
A cervical stitch lowers the chance of early birth in high-risk pregnancies. A review of 15 randomized trials with 3,490 women found cerclage cut the risk of birth before 34 weeks by about 23% (risk ratio 0.77) and probably lowers the risk of the baby dying around birth. (Alfirevic et al., Cochrane Database Syst Rev, 2017)
An emergency stitch can buy about a month when the cervix is already opening. In 757 women whose cervix had started to open between 14 and 27 weeks, babies survived in 71% of pregnancies with a stitch versus 43% without one, and pregnancy lasted about 34 days longer. (Ehsanipoor et al., Obstet Gynecol, 2015)
Adding vaginal progesterone may add extra protection. A meta-analysis of 11 studies found that cerclage plus vaginal progesterone was linked to about half the risk of birth before 37 weeks compared with cerclage alone (risk ratio 0.51); the authors say larger trials are still needed. (Aubin et al., Am J Obstet Gynecol MFM, 2023)
Key takeaways
A cerclage is one or more strong stitches placed in the cervix to keep it closed during pregnancy.
It is mainly used for a weakened (incompetent) cervix or past second-trimester losses linked to the cervix.
The stitch is usually placed at 12 to 14 weeks and removed at about 37 weeks.
It is an outpatient procedure: most people go home the same day.
Plan about 10 days without sex or strenuous exercise while the stitches heal.
The procedure works in nearly 90% of cases.
What is cervical cerclage?
Cervical cerclage is a procedure that keeps your cervix closed during pregnancy so the baby can stay safely inside the uterus until it is time to give birth. [1]
Your cervix is the lower part, or opening, of your uterus. Think of the uterus as a purse and the cerclage as the drawstring that keeps it shut.
During the procedure, your provider places one or several stitches (sutures) in the opening of the cervix. These stitches hold the cervix closed as the pregnancy grows.
If you want to understand the condition behind this procedure, read our guide to incompetent cervix.
Why is cervical cerclage performed?
Cervical cerclage is performed to prevent preterm labor, which is labor that starts before 37 weeks, in people whose cervix is weak. [1]
Your provider may recommend it if you have:
An incompetent (weakened) cervix. This can happen after past surgeries on cervical tissue, such as a LEEP procedure.
Past miscarriages from an abnormally shaped uterus or damage to the cervix.
Past second-trimester miscarriages that suggest a weakened cervix.
Share your full history with your provider, including past pregnancies, miscarriages and any cervical procedures. This helps them decide whether a cerclage is right for you.
When is cervical cerclage done in pregnancy?
Cervical cerclage is usually done at about 12 to 14 weeks of pregnancy, before the cervix starts to thin out. [1]
What happens before a cervical cerclage procedure?
Before a cervical cerclage procedure, your provider reviews your health history and any past problems with pregnancies or cervical surgery. [1]
They will also:
Examine your cervix with a speculum, similar to a routine Pap test.
Possibly do a transvaginal ultrasound.
Likely ask you to avoid sex for one week before the procedure.
Feeling nervous is normal. This visit is a good time to ask every question you have.
What happens during a cervical cerclage procedure?
During a cervical cerclage procedure, your provider numbs the cervix and stitches it closed with strong sutures. [1]
Step | What happens |
1. Positioning | You lie back on an exam table with your feet in stirrups, like a vaginal exam. |
2. Numbing | You get a pain-numbing medicine, such as a local anesthetic. You may feel a small pinch as the needle goes in. |
3. Stitching | Once the area is numb, your provider stitches the cervix closed and tightens it until it is secure. |
4. Monitoring | You stay for a couple of hours to check for problems, then go home the same day. |
Your provider may also give you an antibiotic to help prevent a cervical infection.
Is cervical cerclage painful?
Cervical cerclage should not cause much pain afterward, usually no more than an average menstrual period. [1]
Some cramping and light bleeding or spotting for a few days is normal.
Acetaminophen (Tylenol®) can ease cramping and discomfort.
Intense belly cramping or pain needs a call to your provider right away.
What should you avoid after cervical cerclage?
After cervical cerclage, you should take it easy for about a week to 10 days while the stitches heal. [1]
Activity | What to do |
Rest | Rest on the day of the procedure. Skip work or school that day. |
Sex | Avoid sex for about a week to 10 days. |
Anything in the vagina | Avoid douches and other feminine products during healing. |
Exercise and lifting | Avoid strenuous exercise and heavy lifting until your provider says it is OK. |
Work or school | Most people return to normal activities the next day. |
Follow-up | Keep every follow-up appointment so your provider can monitor the pregnancy. |
When is a cervical cerclage removed?
A cervical cerclage is usually removed when the pregnancy reaches full term, around week 37. [1]
Removal is done in your provider's office. You lie back with your feet in stirrups, and your provider takes out the stitches. It only takes a few minutes.
The cerclage can be removed sooner if your water breaks or you go into labor. Learn the early signs in our preterm labor guide.
What are the benefits of cervical cerclage?
The main benefit of cervical cerclage is that it is the best way to prevent preterm labor when the cervix is weak. [1]
It helps keep the baby inside the uterus longer. The procedure is successful in nearly 90% of cases.
To understand why extra weeks matter, see our guide to premature birth.
What are the risks of cervical cerclage?
The risks of cervical cerclage include infection, bleeding, damage to the cervix and early breaking of the water. Your provider only recommends it when the benefits outweigh these risks. [1]
Risk | What it means |
Infection | Germs can infect the cervix after the stitch. |
Bleeding | Some bleeding can happen during or after the procedure. |
Damage to the cervix | The cervix can be injured by the procedure. |
Premature rupture of membranes | Your water breaks too early. This can trigger preterm labor. |
Preterm labor | Labor can still start before 37 weeks. |
Cervical stenosis | A permanent narrowing of the cervix. |
Scar tissue | Scar tissue can form on the cervix. |
Tearing | The cervix or uterus can tear if labor progresses while the stitches are still in. |
Read more about early water breaking in our guide to premature rupture of membranes (PROM).
When should you call your doctor after cervical cerclage?
After cervical cerclage, call your healthcare provider right away if you notice any of these warning signs: [1]
A high fever over 100°F (37.7°C).
Contractions or lower belly pain that comes at regular intervals.
Foul-smelling vaginal odor or discharge.
Your water breaks or leaks.
Excessive bleeding.
Can a weakened cervix happen again in another pregnancy?
A short or weakened cervix in one pregnancy can happen again in later pregnancies. [1]
If you had a cerclage before, talk with your provider early about planning your next pregnancy. Your provider may track changes in your cervix with checks like those explained in our article on cervical checks. For background on how preterm birth risk is assessed, see this overview from the National Institute of Child Health and Human Development.
Cervical cerclage at a glance
Question | Short answer |
What is it? | Stitches that keep the cervix closed during pregnancy |
Who needs it? | People with a weakened cervix or past cervix-related second-trimester losses |
When is it placed? | About 12 to 14 weeks |
Anesthesia | Pain-numbing medicine, such as a local anesthetic |
Hospital stay | A couple of hours; home the same day |
Healing time | About 10 days before sex or strenuous exercise |
When is it removed? | Around week 37, or sooner if labor starts or the water breaks |
Success rate | Nearly 90% of cases |
Conclusion
Cervical cerclage is a short, outpatient procedure that helps a weakened cervix stay closed so your baby can keep growing until full term. It is placed early in pregnancy, removed around week 37 and works in nearly 90% of cases. Recovery is usually mild, but fever, regular contractions, leaking fluid or heavy bleeding need a call to your provider right away.
Preparing for a cerclage or planning your next pregnancy? Save or share this guide and bring it to your next appointment so you can go through your questions with your provider. Then explore more plain-language pregnancy guides on Rinnit.com, starting with our preterm labor guide.
FAQ
How long does a cervical cerclage procedure take?
Cervical cerclage is an outpatient procedure. You stay a couple of hours afterward for monitoring and go home the same day. [1]
Does cervical cerclage hurt?
You get numbing medicine, so you may feel only a small pinch. Afterward, cramping is usually no worse than a menstrual period and eases with acetaminophen. [1]
Can I have sex after a cervical cerclage?
Avoid sex for about a week to 10 days after the procedure so the stitches can heal. Your provider will tell you when it is safe. [1]
Is cervical cerclage removal painful?
Removal is done in the office and takes only a few minutes, using the same position as a vaginal exam. [1]
What happens if labor starts with the cerclage in place?
The cerclage can be removed early if labor starts or your water breaks. Labor progressing with the stitches still in can tear the cervix or uterus, so call your provider right away. [1]
When can I go back to work after cervical cerclage?
Rest on the day of the procedure. Most people return to work or school the next day. [1]
How successful is cervical cerclage?
The procedure is successful in nearly 90% of cases. [1]
When is a cervical cerclage placed?
A cerclage is usually placed at about 12 to 14 weeks of pregnancy, before the cervix starts to thin. Your provider may suggest a different timing for your situation.
When is a cervical cerclage removed?
A cerclage is usually removed at about 37 weeks. It is removed sooner if labor starts or your water breaks.
Who needs a cervical cerclage?
A cerclage is mainly for people with a weakened cervix or past second-trimester pregnancy losses linked to the cervix. Your provider will decide whether it is right for you.
Related Reading
Incompetent Cervix: Symptoms, Causes & Treatment Guide explains a weakened cervix in pregnancy and how it is treated.
Preterm Labor Guide: Symptoms, Causes, Diagnosis, and Treatment covers preterm labor signs, causes and when to get care.
Transvaginal Ultrasound: Why It's Done, How to Prepare and What to Expect explains how a transvaginal ultrasound checks the cervix and uterus.
What Is a Miscarriage? A Plain-Language Guide to Causes, Symptoms, and Recovery covers miscarriage symptoms, causes, treatment and recovery.
References
Cleveland Clinic. Cervical Cerclage: Purpose, Procedure, Risks & Results. Cleveland Clinic. Last updated April 14, 2022. https://my.clevelandclinic.org/health/treatments/17970-cervical-cerclage
Alfirevic Z, Stampalija T, Medley N. Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy. Cochrane Database Syst Rev. 2017;6(6):CD008991. PMID 28586127. https://doi.org/10.1002/14651858.CD008991.pub3
Ehsanipoor RM, Seligman NS, Saccone G, et al. Physical Examination-Indicated Cerclage: A Systematic Review and Meta-analysis. Obstet Gynecol. 2015;126(1):125-135. PMID 26241265. https://doi.org/10.1097/AOG.0000000000000850
Aubin AM, McAuliffe L, Williams K, et al. Combined vaginal progesterone and cervical cerclage in the prevention of preterm birth: a systematic review and meta-analysis. Am J Obstet Gynecol MFM. 2023;5(8):101024. PMID 37211087. https://doi.org/10.1016/j.ajogmf.2023.101024
Medical disclaimer
This article is for general education only and is not a substitute for professional medical advice. Talk with a qualified healthcare provider about your own pregnancy.
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