My client is due in December and has not had any kind of an easy run with this pregnancy. In a nutshell, she is 20 weeks along, 43, and facing a circlage. Her doctor (or should I say one of many as she is high-risk) had first prescribed her progesterone to help stop the cervix from opening. This was two weeks ago. When they checked her again a few days ago, they discovered her cervix was open (baby is completely healthy btw, no signs of Down's or any distress, just an incompetent cervix). The complications started with bleeding from heavy emotional stress, and was amplified when told she was to be on full bed rest. The father is not in the picture and mama does not want him to be (he is the root cause of the stress), but she has an 8 year old son and while on bed rest, cannot work at all. Basically, what she had asked me to find out was what the feasibility is of how well a circlage will work. If you have had one or a client has, would anyone be willing to share information on it? Her OB/GYN and the high-risk doctor couldn't seem to give her enough information, but I also think she would like to know more out of fear of what could happen after the procedure is done. She's worried about the weight of the amniotic sac over the opening of the cervix. She's afraid to sneeze, pee or make a bowl movement (she still goes she's just afraid) for fear it could worsen anything. The doctors have at least given her the hope that if she can make it to 24 weeks, the baby can survive in the NICU despite probable health issues from underdevelopment. She accepts that terminating the pregnancy is a reality, but holds hope that this won't need to happen (and so far no one has told her that it needs to). Advice? Thoughts?