What is the Bishop Score?

Your Bishop Score provides two important pieces of information:
1) It evaluates how ready your body is for the delivery of your baby and
2) it assesses how easily you would go into labor were you to be induced.

Labor Induction and the Bishop Score

Labor induction is the artificial initiation of labor, which may be recommended when the benefits of birth to the mother or the unborn baby appear to outweigh the potential risks of continuing a pregnancy. Increasingly, both mothers and healthcare providers elect to induce labor for reasons that are unrelated to health.

The Bishop Score is used primarily as a pre-induction cervical assessment tool. For a woman to have a successful vaginal birth, her cervix must be soft, effaced and dilated.

What The Bishop Score Means for You

Labor induction is on the rise, and it is extremely important for every pregnant woman considering this option to be aware of the consequences of a failed induction that may lead to caesarean delivery and / or iatrogenic prematurity (a baby that is premature because the intervention was performed too early). To be able to weigh the options, you should know what your Bishop Score is prior to labor induction.

What is the Bishop Score?

Since the measurements involved relate, primarily, to the state of a pregnant woman’s cervix (the lower part of the uterus, or womb), the Bishop Score is known as a ‘cervical scoring’ system. Developed by Dr. E. Bishop in 1964, in different cases (to determine whether a woman is a good candidate for labor induction).

Which Indicators Does the Bishop Score Measure?

The Bishop Score is a scale based on five indicators:

1. The Fetal Station measures the baby’s descent in the pelvis (lower abdomen). A baby is said to be at ‘zero station’ when it has reached the ‘zero line’ (an imaginary line between the two hipbones or ‘ischial spines’). The baby’s position above the zero line is always a ‘minus’ station and its positions below the zero line are ‘plus’ stations. Stations go from -5 at the pelvic inlet (entrance to the pelvis) to +4 at the pelvic outlet (inferior opening of the pelvis).

2. Cervical Dilation is measured in centimeters (some healthcare professionals measure it in ‘fingers’). A pregnant woman’s cervix is fully open when it is dilated to 10 centimeters. The cervix begins to dilate days (often weeks) before a woman goes into labor. Normally, once active labor sets in dilation proceeds at a much faster pace. Cervical dilation measurements go from 0 centimeters (closed cervix) to 10 centimeters.

3. Cervical Effacement refers to the thinning and shortening of the cervix, which changes the ‘shape’ of the birth canal from a tube into a flaring funnel. Effacement is measured in percent. The cervix of a normal woman who is not pregnant is 0% effaced. When a pregnant woman’s cervix is 50% effaced, it is half its original thickness. At 100% effaced, the cervix is completely thinned out and the mother is ready for vaginal delivery.

4. Position: refers to the position of the cervix. During a pregnancy, the mother’s cervix points backwards (it is in posterior position). Towards the end of pregnancy, the cervix will come forward (anterior position). An anterior position is more favorable for vaginal delivery than a posterior position.

5. Cervical Consistency: the softer the cervix is, the better the chance of vaginal delivery. Consistency is measured on a scale of firmness (firm, medium and soft).

To determine a woman’s Bishop Score, each of the five components listed above is given a score of 0 to 2 or 0 to 3. The highest possible score is 13.

The Bishop scoring system is generally as follows:

The lower your Bishop Score prior to induction, the more difficult induction is likely to be.

An unfavorable (low) Bishop Score may lead to a longer and more painful labor. Induction may even prove unsuccessful and could lead to cesarean birth.

The table below shows estimated caesarian rates for different Bishop Scores:

What can You Do To Increase Your the Bishop Score?

If you are facing the risks of medical labor induction, use maternity acupressure to improve your Bishop Scores.

Specific maternity acupressure points helps your baby to descent (increases your Fetal Station –score) and helps your cervix to dilate and thin down (Cervical Dilatation and Cervical Effacement – scores) and therefore to increase your changes for a normal and safe delivery.

Maternity acupressure can eventually help you to avoid the medical labor induction because it has proven to be an effective way to induce labor naturally .