Information Sheet

Cervical preparation

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Before your surgical abortion procedure, we may use “cervical preparation” to help soften and relax the cervix (neck of the womb). Cervical preparation reduces the risk of damaging the cervix and helps with the safe completion of your procedure.

There are two ways to prepare your cervix – using misoprostol or osmotic dilators. Your doctor may discuss using of one or both methods.

What is misoprostol?

Misoprostol is a type of medicine called a prostaglandin.  Misoprostol is commonly used for cervical preparation, although it is not registered in Australia for this use. Misoprostol also lowers the chance of retaining pregnancy tissue or blood clot after the procedure.

You will need to wait up to 4 hours after being given misoprostol for it to work and must stay in the clinic until your procedure. The time needed will depend on how many weeks pregnant you are and whether you have had a vaginal birth before. During this time, you may have cramping, vaginal bleeding, chills, nausea and diarrhoea. In rare cases you may miscarry the pregnancy during this time. If you think this is happening, tell a nurse immediately.

Once misoprostol has been given, the abortion procedure has started. If you decide not to proceed with the abortion, there is a risk of damage to the fetus and of miscarriage at a later date.

What are osmotic dilators?

Osmotic dilators are small rods with a string attached to one end. Several rods are placed in the cervix, usually under intravenous sedation.

Over a period of several hours, or overnight, they absorb moisture and swell up, gently opening the cervix and causing it to soften as well.

Once the rods have been put in the abortion procedure is considered to have started. You will rest in the recovery area until your procedure or be discharged home if the rods are to stay in overnight.

During this time, you may have cramping, nausea and vaginal bleeding. If the rods are staying in overnight, you will be prescribed pain relief medication to take at home. You may also notice some straw-coloured fluid leaking.

Occasionally the rods may fall out overnight, but this usually means that they have done their work. The longer they stay in the better, so don’t try to pull them out. Make sure to tell the doctor if you think a rod may have come out.

Very rarely, the rods may cause the rapid start of miscarriage. If you think this is happening, tell a nurse immediately. If you’re at home, contact us immediately and be prepared to go to your nearest Emergency Department.

If you are concerned about anything, phone Aftercare on 1300 888 0222 to speak with a nurse.

This page last edited: March 2023
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