What Does Your Bishop Score Mean for Labor and Delivery?
The last few weeks of pregnancy can feel equal parts exciting and stressful. You’re busy making sure everything is ready for baby and preparing for life with a whole new family member. At the same time, you’re contending with some serious uncertainty about when and how baby will make their big debut. This can feel particularly unnerving if your due date has come and gone. Fortunately, your Bishop score, which measures several cervical conditions, can help shed some light on just how near labor may be. Calculating a Bishop score isn’t an exact science, but it can help your provider make an educated prediction about your body’s readiness, and allow them to determine whether you might be a good candidate for induction. So how does it work, and what exactly does your Bishop score say about your potential labor and delivery experience? Read on for the full lowdown.
When your body prepares for labor and delivery, your cervix—the small canal that connects your uterus and vagina—starts to soften, thin out and open, according to the American College of Obstetricians and Gynecologists (ACOG). These changes usually start a few weeks before labor begins.
As your due date approaches, your provider may check your cervix to see if it’s favorable for labor. If you’ve gone past your due date, they may use a Bishop score to track the changes happening in your body, notes the Cleveland Clinic.
Developed by Edward H. Bishop, this score essentially helps your provider evaluate how “ready” your cervix is for induction of labor, while helping to predict the chance of a successful vaginal delivery, explains Meleen Chuang, MD, medical director of women’s health at the Family Health Centers at NYU Langone.
For the record, Bishop score usually isn’t something doctors typically discuss with patients. “It’s a clinical tool that’s helpful for communicating among clinicians,” says Matthew Carroll, MD, assistant professor of obstetrics and gynecology at Baylor College of Medicine in Houston. “For patients, it is easier to discuss whether a cervix is favorable (ready for labor) or unfavorable (needs preparation for labor.”
A Bishop score gives you a number that doctors can then interpret. “The higher the score, the easier labor is likely to get started with induction medication,” says Jonathan Schaffir, MD, an ob-gyn at the Ohio State University Wexner Medical Center.
There are five different components of your cervix that contribute to an overall Bishop score, Chuang says. These include:
- Cervical dilation (how open your cervix is)
- Cervical effacement (how thin it is)
- Cervical consistency (how firm or soft it is)
- Cervical position (it moves forward as labor approaches)
- Fetal station (the position of baby’s head in relation to your pelvis)
“Points are assigned to each of these measurements, with a maximum [score] of 13,” Schaffir says.
After they examine you, your provider will assign you a Bishop score. Keep in mind that you may need to proactively ask for this number if you’re curious. “I don’t usually provide a score to patients,” Schaffir says. Carroll agrees that it’s “rare” that he’s asked by a patient about their Bishop score. Still, if you happen to get your Bishop score, here’s a breakdown of what it likely means, according to Chuang:
- Five or less points: Your body isn’t prepared for labor, and it’s not likely to start naturally
- Six to seven points: You may or may not have a successful induction. Your doctor will need to make a judgment call.
- Eight or more points: Labor will probably start soon. If you’re induced, you’ll likely be able to have a vaginal delivery.
Your Bishop score can help a provider determine if you may need help dilating during an induction and, if so, what methods may be most effective. “With a score of six or less, a patient planning an induction will likely need to use medication or a mechanical dilator to soften the cervix at the start of induction,” Schaffir says.
It’s important to know that there’s no definitive Bishop score calculator, and it’s a relatively subjective measurement. “The Bishop score is not a highly scientific measurement since it relies on the healthcare provider’s experience and judgment,” Chuang says. While the Bishop score is widely used, it’s not a foolproof predictor of labor outcome.
Other factors, like your medical history, how well baby is doing and your overall health play major roles in any decision making around your labor and delivery. “The Bishop score is one of many tools your provider uses to assess cervical readiness,” Chuang says. “Your provider always considers multiple factors and individualizes your care based on your unique circumstances.”
If you have questions about what your Bishop score means or when baby may arrive, talk to your team. They should be able to help walk you through it. In the meantime, hang in there—baby is coming sooner or later.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Matthew Carroll, MD, is an assistant professor of obstetrics and gynecology at Baylor College of Medicine. He earned his medical degree from the Mount Sinai School of Medicine in New York City.
Meleen Chuang, MD, serves as clinical associate professor and medical director of women’s health at the Family Health Centers at NYU Langone in New York City. She earned her medical degree from SUNY Stony Brook.
Jonathan Schaffir, MD, is an ob-gyn at the Ohio State University Wexner Medical Center. He earned his medical degree from Brown University in Providence, Rhode Island.
American College of Obstetricians and Gynecologists (ACOG), Labor Induction
Cleveland Clinic, Bishop Score, Oct. 2022
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