For expectant mothers, the commencement of labor is an immensely anticipated process. Medical professionals use a set scale of analysis designed for people nearing the very end of pregnancy that assesses how well the body is preparing for labor and vaginal delivery. This scoring system is known as the Bishop score.

If you’re wondering what the Bishop score is and why it is important, let’s examine this part of the childbirth preparation process.

The Historical Purpose of the Bishop Score

So what is the Bishop score, and why is it important? Developed by Dr. Edward Bishop in 1964, the Bishop score is a set scale that assesses the ripeness of the cervix for a vaginal delivery.

The American College of Obstetricians and Gynecologists states that the Bishop score is used to rate the readiness of the cervix for the onset of labor and to determine if the process may begin sooner with an induction method. After labor begins, the cervix should soften and widen to allow for the baby’s passage. If not, a health care provider must decide the best way to proceed with delivery.

How It’s Calculated

The Bishop score reviews 5 areas of focus to calculate a total score. The scale ranges from 0 to 13. Providers will examine these varying metrics via physical exams or digital ultrasounds. The higher the score, the more likely the chance of a vaginal delivery, either natural or induced. Anything below 5 points is less likely to lead to a vaginal delivery.

The Bishop score assesses the cervical length, diameter, firmness, and position. Here are further details about these key determining factors.

Cervical Consistency

Consistency refers to the softness or firmness of the cervix. The given score is between 0 and 2 points.

Cervical Dilation

Dilation refers to the widening of the cervix before labor. Some women do not experience dilation prior to the day of labor, while others may already be dilated a few centimeters in the weeks before labor. The given score is between 0 and 3 points.

Cervical Effacement

Effacement refers to the thinning and shortening of the cervix before childbirth. This is determined by comparison with pre-labor cervix length percentages. The given score is between 0 and 3 points.

Cervical Position

Professionals also assess how far the cervix lowers to prepare for the baby’s descent. The positioning of the cervix is given a score on a rating scale between 0 and 2 points.

Fetal Station

Generally, the fetus should also start to move into the correct position for birth. Fetal station refers to the position of the baby’s head in relation to the mother’s pelvis. The given score is between 0 and 3 three points.

Common Methods for Cervical Ripening

If induction of labor is necessary, effective cervical ripening methods are key to a safe vaginal delivery. Medical professionals may use high-quality devices such as an amniotic hook to break the water or recommend medications to soften the cervix and stimulate dilation.

Moms-to-be and their birth partners can discuss with their chosen health care providers if inducing is the best option based on their Bishop score result, health concerns, and personal preferences. Either way, the health and safety of mom and baby are the top priorities.