Cervical ripening may be achieved either by mechanical means, such as with osmotic dilators, or biochemically with prostaglandins. Solid evidence supports the efficacy of misoprostol for cervical ripening before first-trimester suction curettage abortion. A consensus has emerged that the optimal treatment regimen to use is 400-μg misoprostol 3-4 hours pre-operatively, with vaginal administration being superior to the oral administration. However, two studies using 400-μg misoprostol via the oral and vaginal routes have previously shown that this does not result in satisfactory pre-operative dilatation in the majority of Norwegian women, and we have recommended that the minimum dosage be greater than 400-μg vaginal misoprostol fours hours pre-operatively.