Mid trimester miscarriage and premature birth remain a significant cause of perinatal morbidity and mortality presenting an important challenge in perinatal medicine. The place of cervical cerclage requires to be reconsidered and redefined. Insertion of a cervical suture may be useful when there is cervical weakness in a woman at risk of miscarriage or premature birth. Miscarriage is a preferable word to abortion and weakness is a preferable word to incompetence because of the sensitivities of the woman in this situation.