Friday, July 2, 2010

Induction Musings: The Bishop Score

Is your doctor recommending inducing labor? Have they told you what your Bishop Score is? No, you say? I didn't think so. A Bishop Score is a tool that can be used to give an idea of how sucessful an induction will be in terms of it resulting in a vaginally born baby. Generally, when I ask parents if their OB has told them their Bishop Score before induction, they will look confused and say no.

I believe that doctors don't share this information for two reasons. One: a less informed patient is a more compliant patient. The less you know, the less you argue with the experts. Two: at the end of the day, it doesn't matter to them if the baby comes out vaginally or surgically. They still get paid.

Here's what you need to know: The Bishop Score is a group of measurements that can be used to determine if an induction would be sucessful or if it would be better to wait or to try cervical ripening methods before doing things like breaking your water or using pitocin.

The Bishops Score generally follows this scale:
Score   Dilatation      Effacement       Station        Position       Consistency
0          closed              0 – 30%             -  3            posterior               firm
1          1-2 cm              40 -50%              -2             mid-position    moderately firm
2          3-4 cm               60 -70%            -1,0            anterior                soft
3           5+ cm               80+%                 +1,+2

A point is added to the score for each of the following:
Each prior vaginal delivery

A point is subtracted from the score for:
Postdates pregnancy
Premature or prolonged rupture of membranes

cesarean rates: first time mothers ---  women with past vaginal deliveries

scores of 0 – 3:   45%                                     7.7%
scores of 4 - 6:    10%                                     3.9%
scores of 7 - 10: 1.4%                                      .9%

In other words, the closer to 10 your score is, the more likely it is that your induction will end with a vaginal birth. The lower the score, the more your risk for a surgical birth increases.
If your doctor is talking induction, ask them "What is my Bishop score? What are the benefits of inducing now? What are the risks of waiting? What if I want to wait?"
Bishop score stats taken from

1 comment:

  1. I was induced with both my babies. I, luckily, responded well to induction; had fairly quick labors, didn't have to have a c-section, and recovered quickly. I didn't even reach my "due date" with either. Both of them put me through so many episodes of contractions that dissapated after several hours, that I got REALLY tired of the rollercoaster of thinking it was time, just to be let down. If I had had the knowledge you have shared, and the knowledge from the nurse who finally really explained how contractions should feel when it's TRULY time to go to the hospital, I think I could have been patient enough to let them come on their own. If I have another baby, I will put this knowledge to use. And probably come back and read it at 37 weeks when I start getting impatient as a reminder why I don't need to be!