The Ethics of Transabdominal Cerclage Placement

Cervical insufficiency is present in up to 1 percent of pregnancies and is involved in a significant portion of pregnancy losses in the second trimester. The first line of treatment for most women with this condition is transvaginal cerclage. However, for some this is not sufficient, and a transabdominal cerclage must be performed. In a subset of women who receive transabdominal cerclage, there has been documented concern about subfertility. To the lay person, this may raise concerns that this approaches a contraceptive effect which would have implications on the liceity of the treatment; however, consideration of the current research on the procedure indicates that the subfertility is not a result of cerclage on its own, and ethical analysis through the principle of double effect further affirms the morality of this treatment.