If you’re nearing the end of your pregnancy, it’s quite possible your provider has brought up induction to you. It is a rather common occurrence in our current birth culture both electively and for medical need. The Bishop’s Score can give you a good idea of where your body stands and the likelihood that your induction will be successful.
The Bishop’s Score assigns a score from 0 to 3 in five different categories: position, consistency, effacement, dilation, and station.
Position refers to the position of your cervix: posterior (0), mid-line (1), or anterior (2). Typically your cervix moves from a posterior position during pregnancy to an anterior position for birth. Your provider probably won’t mention this unless you ask.
Consistency refers to how soft your cervix feels to the touch: firm (0), medium (1), or soft (2). Your cervix tends to soften the closer you are to labor, which is why cervical ripening agents are applied as the first step to many inductions. Your provider may or may not give you this info, so ask if you’re interested in calculating your score.
Effacement is how thinned out your cervix is: under 30% (0), 30-50% (1), 60-70% (2), and over 80% (3). Your doctor will usually give you this information at routine vaginal checks towards the end of your pregnancy.
Dilation is the most well-known sign of labor progress, even if it’s not necessarily all that telling. The score is assigned: closed (0), 1-2cm (1), 3-4cm (2), and 5+cm (3). Your provider will definitely give you this information as long as you haven’t requested to not hear it. It is the part that most people focus on, but as you can see from this list, is not the only thing your cervix needs to do for a baby to come through it.
Station refers to where the baby’s head is in relation to the ischial spines (an imaginary line drawn across your pelvis basically) that indicates how low the baby’s head is (-5 being floating and not at all engaged to +5, which is crowning). Scores are assigned as: -3 (0), -2 (1), -1 (2), and +1 up (3).
Having your Bishop’s Score can help you go into an induction with an idea of where you stand.
You can calculate this yourself or you can use an app (yay technology!). If you’re wanting to know your Bishop’s Score before agreeing to an induction, be sure to ask your provider to tell you where you stand with each factor. It isn’t usually common practice to give info in all of these categories, so you will need to request it. You could also ask your provider to calculate your score for you. A score of 8 or higher is considered favorable for induction, and 6 or lower is unlikely to result in a vaginal birth. A simplified version of the score using only dilation, station, and effacement (with a score over 5) has also shown to have predictive value.
As with anything, people are not statistics.
This is a good starting place, but you never know how your body will respond to induction. Or birth in any situation, for that matter. It may go perfectly well even without a perfect score.
