Birth Toolbox: Do You Know Your Bishop Score?

Near the end of pregnancy it’s common for the cervix to enter the spotlight, as cervical exams are often offered at each appointment starting around week 36. Even friends and family become invested in what exciting things your cervix is up to, the question of dilation arising again and again in conversation!

If your number is high, it’s likely met with excitement and bets that you’ll go into labor any minute; if it’s low, you may swear you’ll never have this baby.

But there’s more to predicting labor than dilation.

Your provider will evaluate your cervix based on five factors: dilation, effacement, position, consistency, and station.

Dilation refers to how dilated (or open) your cervix is, and will be measured in centimeters (1-10). 

Effacement refers to the shortening and thinning of the cervix, as the cervix starts out long and thick but becomes short and papery thin as things progress. Effacement is described in percentages, such as, “You are 70% effaced.”

Position refers to the position of the cervix relative to the fetal head and maternal pelvis; essentially, it’s the direction the cervix is pointing: forward (anterior), middle (mid), or backward (posterior).

Consistency describes the firmness of the cervix: Is it very firm? Kind of firm (medium)? Or is it soft?

The final factor to be evaluated, Fetal Station, isn’t technically a cervical evaluation, but instead an evaluation of the location of the fetal head in relation to the ischial spines of your pelvis. Negative numbers indicate that baby is high, or above the ischial spines, and not really engaged in the pelvis; positive numbers, then, indicate that baby’s head has descended into the pelvis below the ischial spines.

 

Each of these categories will be scored using a points system, and the resulting score is your Bishop Score (on a scale of 1-10). 

 

Does your Bishop Score matter? 

It’s true that regardless of how high or low your score is, you could go into labor at any time—things can change very quickly when it comes to birth!

But there are at least two instances where knowing your Bishop Score may help you make a more informed decision for yourself and your baby, and to do so more comfortably: 

-If you’re considering an induction.

You see, the Bishop Score is most often used to predict the likelihood that an induction will lead to a vaginal delivery. The higher the score, the greater the likelihood that this will occur. Think of it as just one more piece of the puzzle to consider when electing if and when to have an induction.

-If you’re considering different methods of induction.

Suppose you need to be medically induced due to concerns for yours or baby’s health. If your Bishop Score is high, you and your provider may opt for jumping right into labor by breaking the bag of waters or inducing/augmenting contractions.

Alternatively, if your Bishop Score is low, suggesting your cervix may not be ready for labor, you and your provider could consider a variety of cervix ripening techniques for beginning the induction.

 

In the end, the Bishop Score is just one more tool to add to your birth toolbox.

Sure, it may collect dust there.

But it may also prove a useful guide if you reach a fork in the road on your journey to parenthood and are looking for the next right path for you and your family.

 

Wondering how to calculate your score? Use this nifty online calculator, or head to the App Store and download one for free!