Cerclage is a procedure in which a suture (stitch) is placed around the cervix in a purse-string fashion with the intention of keeping the cervix closed and thus sustaining the pregnancy. Most Obstetricians today use the Macdonald type of removable suture, and when the pregnancy gets to term they remove the suture to allow for vaginal delivery. A permanent type of cerclage is the Shirodkar type of cerclage, which when successful, is left in place for future pregnancies. Today, this has fallen out of favor and the vast majority of Obstetricians use the Macdonald type. The procedure is usually outpatient, lasting only 10-15 minutes and performed under spinal anesthesia.