Considering an induction? What's your Bishop score?
- Amalhopebirthing
- Sep 29, 2024
- 3 min read
What on earth is a Bishop score?
The Bishop Score is a cervical assessment method developed by Dr. Edward Bishop in 1964 to predict the likelihood of a vaginal birth when induction is necessary.
In other words, if you are at the end of your pregnancy and about to pop, your doctor or midwife might use the Bishop Score method to determine whether you should be induced or not and whether it will be a success.
There are mixed results from studies that have been done as to the effectiveness of this method, yet most health care providers continue to use this system regardless.
To know your Bishop score, your care provider will do a vaginal exam and look for specific information from five different components. Based on the outcome of these components, you will receive a score between 0-12.
A high Bishop score means you have a higher chance at a successful induction. A lower Bishop score means a lower chance of a successful induction and slim chance of a vaginal birth.
These are the 5 components:
Dilation
- This refers to the opening of your cervix. It is measured in centimeters and is an important indicator of labour progression.
Effacement
- This refers to the thinning of your cervix. Your cervix is approximately 3cm long, and as you continue to prepare for labour, it will thin out until it is paper thin.
Position
- The position of your cervix changes from a posterior (the back) position to become more anterior (facing the front nearer to the opening of your vagina) as labour comes closer.
Consistency
- This refers to how the cervix feels. In women who are first pregnant, their cervix feels quite firm and is usually tougher and resistant to stretching. With more pregnancies, the cervix becomes less firm and allows for easier dilation.
Baby’s station
- This describes the position of the baby’s head in the pelvis in relation to the ischial spines. The ischial spines are referred to as the midline of the pelvis. The care provider will visualize where these spines are and use them as a reference point. Negative numbers mean baby’s head is further inside and positive numbers show that baby’s head is below the level of the spines.
If your Bishop score is higher than 8, then most likely your body is ready to go into spontaneous labour soon. You may choose to be induced at this point which means you’ll probably have a fast and easier vaginal delivery.
If your Bishop score is a 6 or a 7, then your body isn’t quite ready for labour yet. If you do choose to get induced, it might end up with you needing more interventions and may or may not end up with a vaginal birth. It would be wise to weigh the pros and cons.
If your Bishop score is a 5 and lower, it means your body is most likely far off from spontaneous labour. An induction at this point will most likely not be successful.
Are Bishop scores the final say so?
No, they are not. Even though Bishop scores may be a helpful tool, it does not need to have the last word. Your score does not necessarily mean the outcome it predicts.
If you’re worried that you have a low Bishop score, know that there are plenty of factors that might be causing it. Maybe your baby’s position is not optimal yet. Or maybe you’re a woman who dilates faster when you’re in active labour.
Natural Inductions to try
Nipple stimulation – the gentle rubbing or rolling of nipples releases the hormone oxytocin which is responsible for getting contractions going.
Sexual intercourse– semen is a natural prostaglandin, which is a hormone that helps to ripen the cervix.
Dates – eating 4-6 dates every day after 38 weeks, prepares your uterine muscles to respond better to oxytocin, which leads to contractions.
Walking – helps get baby into better position and deeper into the pelvis.
Acupuncture
From my own personal experience, I know it can be quite frustrating wondering if labour will ever start. My little girl was born at 42 weeks. Boy, did it feel like I waited forever!
But I'd like to encourage you to trust your body and your baby. If you and baby are healthy, then most likely you will go into labour when baby is ready to come.
It's good to know that you have options and time to help baby get into a better birthing position, as well as more natural inductions to try before you think about induction. Ideally, you want to get your Bishop score higher if at all possible.
You've got this mama!
In hope,
Esther
Sources
EDC Training Manual
The Christian Childbirth Handbook
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