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What's Your Score?

You’re 39 weeks- swollen, exhausted, waddling, etc. The thought of choosing baby’s birthday and ending this journey now is starting to sound very appealing. STOP! Do you know what your bishop score is or why it matters? I get it momma, you’re tired and SO ready to meet your sweet babe. But let me give you some background information to aid in your decision making. After all there is great empowerment in knowing your options and making informed decisions, so read on!

The Bishop Score

In the 1960s, Dr. Edward Bishop coined the term “Bishop Score” as a cervical scoring system used to determined the likelihood that an elective induction would be successful or could be used to determine when an induction may be necessary. The bishop score rates information gained from a vaginal examine on a scale of zero to thirteen. The higher the score the greater the likelihood of spontaneous vaginal delivery (or successful induction). The lower the score the lesser likelihood of spontaneous vaginal delivery (or successful induction). Based on his research, he found that women with a score 8 or higher had the best chances of spontaneous delivery or a successful induction.

What determines your score?

  • Dilation - determines the distance that the cervix is opened measured in centimeters.

  • Effacement - measured in percentages from zero (normal cervix) to 100%. These numbers are used to determine the thickness of the cervix. When the cervix is 100% effaced (thinned) it will be paper thin.

  • Station - this part of the score is the position of the baby’s head in relation to the pelvis. When a baby’s head is “engaged” in the pelvis, their head is in line with the bony, ischial spines. When baby is engaged and in line with the ischial spines, the head is at 0 station. These bony structures help to divide the pelvis into three sections -

  1. Inlet: Baby’s head is above the ischial spines. Baby is considered “high”. Station is labeled by negative numbers -2, -3.

  2. Midpelvis: Stations are labeled as -1, 0, +1

  3. Outlet: Baby’s head is below the ischial spines. Baby is considered “low”. Station is labeled as +2, +3.

  • Consistency - the texture of the cervix (firm, medium, or soft)

  • Position - the position of the cervix (posterior, middle, or anterior)

Why does it matter?

I do believe that sometimes, as unfortunate as it is, inductions can be medically necessary. I am thankful for excellent doctors and modern medicine for when inductions are truly needed. BUT, that being said - there are plenty of low risk women who benefit from waiting for spontaneous labor. I get it, the end of pregnancy is hard and the days are long, but patience is your friend! Electing for an induction when your body is clearly not ready could (not always) lead to more unnecessary interventions or risks. If you and baby are perfectly healthy with a low bishop score, it may be in your best interest to wait things out a little longer!

Scoring Process

There is also an app you can download that will help you calculate your score!

Things to consider

Being educated and making informed decisions is SO important. Maybe you are full term with a low bishop score, but if you’re also showing true signs of preeclampsia, then it may be time to consider an induction, as preeclampsia can be very dangerous. While there are risks, many women go on to have normal births after inductions. Maybe you’re past your “due date” and still facing a low bishop score- this may be a good time to consider baby’s position. Sometimes baby can be in a less than ideal position that could be delaying cervical progress. Improper positioning can keep baby’s head from being in the appropriate place to put the right kind of pressure on the cervix so that it can begin thinning and dilating. This is when things like Spinning Babies and Miles Circuit can be helpful!

Bottom Line

While the bishop score can be a useful tool in determining your body’s readiness for birth, it isn’t the end all be all. I encourage you mommas reading to stay strong and have patience. Ask questions! If you are considering an induction, that is absolutely your choice to make, just be sure you have all of the information needed. Get checked, ask about your score, and work with your care provider to determine the best and safest plan for you and baby! I wish you well, happy birthing!