“…A survey of US abortion providers in [2006][2007] showed that 86% of providers used osmotic dilators and 74% use both osmotic dilators and misoprostol for preprocedure cervical preparation [8]. There is insufficient evidence to define the number of dilators or length of time required for cervical preparation for D&E, but after 19-20 weeks, expert opinion recommends at least 1 day of cervical preparation [4]; one or two sets of osmotic dilators placed 24-48 h prior to the procedure is common clinical practice [9]. Protocols requiring multiple-day preparation may be particularly burdensome for patients traveling to obtain an abortion, requiring more time off work and money for hotel accommodations, in addition to the discomfort of repeated outpatient procedures to place osmotic dilators.…”