Cervical cerclage - Questions for your care provider
This page was created in response to research highlighting the emotional, physical and psychological challenges faced by women undergoing cervical cerclage in pregnancy. While a cerclage can offer reassurance by supporting the cervix and reducing the risk of midtrimester loss or preterm birth, many women describe a parallel experience of uncertainty, fear, and isolation—particularly when professional advice on activity restriction is vague, conflicting or inconsistently delivered.
A recent qualitative study published in BJOG (Lou et al., 2025) explored the lived experiences of Danish women who had undergone transvaginal cervical cerclage. Despite receiving what is often framed as a preventive intervention, participants reported feeling burdened by responsibility, hypervigilant to bodily symptoms, and unsupported by fragmented care.
This list of 32 specific, evidence-informed questions has been developed to help women prepare for conversations with their healthcare providers. It aims to facilitate more transparent communication, enhance shared decision-making, and reduce the psychological load often carried in silence.
Understanding my diagnosis and treatment
1. Can you clearly explain why my cervix shortened or weakened, and how exactly the cerclage will help keep my pregnancy safe?
2. How effective is cervical cerclage in preventing preterm birth in cases similar to mine, and are there different success rates for elective versus emergency cerclage?
3. After the cerclage, what signs or symptoms might indicate it’s not working effectively?
4. Is there anything specific I can do to maximise the success of the cerclage?
Specific guidelines on activity restrictions
5. Can you clearly outline what ‘moderate activity restriction’ means—exactly how long can I stand, walk, or sit each day?
6. If I’m placed on complete bed rest, does this literally mean staying in bed all day, or can I briefly move around my home for bathroom use or meals?
7. Are stairs completely off-limits, or can I safely manage them occasionally?
8. Can I safely perform daily hygiene routines independently (like showering or bathing), and if so, what specific precautions should I take?
Managing physical health and wellbeing
9. Given prolonged bed rest, how can I prevent muscle weakening? Are there safe stretching exercises or movements I can do in bed?
10. What specific measures can I take to reduce risks of blood clots or other complications related to extended immobility?
11. Are compression stockings recommended, and if so, how often should they be worn?
12. How should I handle common physical discomforts from bed rest, such as back pain, hip pain, or constipation—are there safe strategies or medications?
Monitoring and responding to bodily signals
13. How exactly can I distinguish normal pregnancy discomfort from genuine warning signs like preterm contractions or cervix issues?
14. If I experience vague symptoms like pelvic heaviness or mild cramping, at what precise point should I contact you or seek emergency care?
15. Is there a clear timeframe or number of contractions per hour that would indicate a serious concern?
16. Can you demonstrate or clearly describe how I can self-monitor effectively for early labour symptoms or cervical changes?
Emotional and psychological support
17. Can you recommend specific psychological support or counselling services specialising in high-risk pregnancies or prolonged bed rest?
18. Are there any reputable online or local support groups you specifically recommend for emotional and practical support during this challenging time?
19. What symptoms or feelings should alert me that I might need professional mental health intervention or support?
20. Could regular check-ins or brief telehealth calls be arranged to address my emotional wellbeing and reduce anxiety between scheduled appointments?
Ensuring continuity, consistency, and quality of care
21. Is it possible to have one consistent obstetrician or specialist throughout my pregnancy, rather than rotating providers?
22. How can we ensure that each healthcare professional involved in my care fully understands my history and specific treatment plan to avoid conflicting advice?
23. Could my medical notes or care plan include clear, standardised instructions for all healthcare providers to follow?
24. If I receive conflicting information, what is the best way for me to clarify or confirm the correct advice quickly?
Supporting my partner and family
25. How can my partner be best involved in my medical appointments and decision-making processes to reduce their anxiety?
26. Can you suggest specific ways my partner can practically support me at home to reduce physical and emotional strain?
27. Are there any recommended counselling or support resources specifically for partners or family members of women with high-risk pregnancies?
28. How can we openly discuss and manage feelings of guilt or worry that both my partner and I may experience due to this pregnancy situation?
Planning for birth and postpartum recovery
29. Considering my prolonged bed rest, how might this specifically affect my labour, delivery method, or options for pain relief?
30. Are there specific precautions or special monitoring required during labour and delivery due to the cerclage or physical deconditioning?
31. What kind of postpartum physical rehabilitation or physiotherapy should I plan for immediately after delivery and in the longer term?
32. How soon after birth should I begin addressing physical rehabilitation, and what initial gentle exercises or movements might be recommended?