 | You may be wondering, “When will I go into labor? Will I need to be induced or will I want to get things moving, either naturally or medically?” We tend to get excited and anxious to get baby out, whether it’s our first or sixth, but what are the benefits and risks of inducing labor and how would a Bishop Score, that you may or may not have ever heard of, help you know if inducing is the right route to go? |
History of the Bishop Score
If you are having any sort of medical professional, OB/GYN, midwife or family doctor attend your birth, they will most likely be using the assessment of the Bishop Score.
In the 1960s, Dr. Edward Bishop developed a pelvic scoring system, called the Bishop Score, using cervical dilatation, effacement, station, consistency, and position to determine how likely an elective induction would be beneficial, if it would be successful, and whether or not it would be necessary. Based on his research, he concluded that elective induction would be most successful in women who had a score of 8 or greater, out of a total score of 13 points.
More research had shown that cervical dilation was the biggest factor in whether or not an induction would be successful, but using dilation in the scoring didn’t change the accuracy of predictions.
Some practitioners have used modifications such as adding a significance for the presence of preeclampsia or previous vaginal deliveries, adding 1 point for each previous birth. Then, subtracting a point for being past her due date (40 weeks+), no previous vaginal deliveries and having had a pre-term premature rupture of membranes.
There has been no evidence to support these modified scores being better than the original Bishop score.
In the 1960s, Dr. Edward Bishop developed a pelvic scoring system, called the Bishop Score, using cervical dilatation, effacement, station, consistency, and position to determine how likely an elective induction would be beneficial, if it would be successful, and whether or not it would be necessary. Based on his research, he concluded that elective induction would be most successful in women who had a score of 8 or greater, out of a total score of 13 points.
More research had shown that cervical dilation was the biggest factor in whether or not an induction would be successful, but using dilation in the scoring didn’t change the accuracy of predictions.
Some practitioners have used modifications such as adding a significance for the presence of preeclampsia or previous vaginal deliveries, adding 1 point for each previous birth. Then, subtracting a point for being past her due date (40 weeks+), no previous vaginal deliveries and having had a pre-term premature rupture of membranes.
There has been no evidence to support these modified scores being better than the original Bishop score.
So What is My Bishop Score and What Does it Mean?
Click here to determine your Bishop Score. Once you have your score, here is what it means.
A high Bishop score means you have a higher chance at a successful induction. A low Bishop score means you have a lower chance at a successful induction.
It is always encouraged, even with this information, to make the decision for yourself, especially if you and baby are healthy. Just because your score is lower or higher, doesn’t mean that the opposite outcome can’t happen. You know your body best, and if induction doesn’t feel right for you, you always have a chance to decline and wait. Also, 42 weeks is not an indicator for induction. Many women go past 42 weeks. It would be in your best interest to check with your care provider or doula to help encourage baby to get in a better position, because sometimes women don’t go into labor because baby isn’t engaged correctly.
A high Bishop score means you have a higher chance at a successful induction. A low Bishop score means you have a lower chance at a successful induction.
- 8 or more points will most likely mean that you may start labor spontaneously, and maybe even soon! It can also indicate that if an induction is necessary, it will most likely be successful.
- 6 to 7 points means the test isn’t a great predictor one way or the other, so you could have a successful or unsuccessful outcome.
- 5 or fewer points would indicate that an induction is less likely to be successful. It can also mean that a woman who isn’t feeling well or is close to the 42 week mark is in need for an induction.
It is always encouraged, even with this information, to make the decision for yourself, especially if you and baby are healthy. Just because your score is lower or higher, doesn’t mean that the opposite outcome can’t happen. You know your body best, and if induction doesn’t feel right for you, you always have a chance to decline and wait. Also, 42 weeks is not an indicator for induction. Many women go past 42 weeks. It would be in your best interest to check with your care provider or doula to help encourage baby to get in a better position, because sometimes women don’t go into labor because baby isn’t engaged correctly.
Should I choose to medically or naturally induce?
 | Unless there is a health concern for you and/or the baby, it may be best to naturally induce instead medically induce. Medical induction has many side effects, while natural ways of inducing may cause less stress on you and the baby. |
Medical Inductions
Once you are in the hospital to get induced, there is no turning back. You are now on the hospital and doctor’s time clock, your risk of infection can increase, and the risk of stress to the baby jumps significantly. While inductions can serve a purpose and may be helpful, for the low-risk, healthy, pregnant woman, there isn’t a need. Depending on your Bishop score, you will want to talk to your care provider about different ways to induce.
Natural Inductions
Again, natural inductions have less risk, and if they don’t work, you can continue to try them until they do. Also, you can do them comfortably in your own home. So if you have a good Bishop score and you're past your due date, you may try out these natural methods of induction.
- RELAX! Erase all fear and anxiety, breathe, be patient, and stay calm.
- Practice the Miles Circuit! Practice this in the weeks coming up to your due date, past your due date and even in early labor.
- Exercise! Movement is KEY before and during labor. Walk, stair climb, swim, yoga, belly dance, using your birth ball, all great ways to keep the pelvis mobile.
- Acupressure/Reflexology! Check out these 9 spots on your body to use for easing labor pains and helping bring on labor.
- Nipple Stimulation! Get your natural oxytocin flowing by having your partner or yourself stimulate your nipples. One breast at a time for 15 to 30 minutes. Standing facing the shower and letting the water hit you and run over you is helpful, too.
- Sex! Some midwives say that the best way to encourage labor to start and to keep it going is to stimulate it the same way the baby was made. Sex isn’t recommended once your bag of waters was broken, but it would be a great thing to do before to stimulate oxytocin. Your partner’s semen will possibly help to ripen your cervix, too. External stimulation would be fine after your bag of waters is broken.
- Use Clary Sage and Rosemary essential oils! Diffuse them, use on acupressure points listed above, and smell drops on a cloth or on hands.
- Midwives Brew! Here is the recipe.
- Eat pineapple or spicy foods!
How Important is Your Bishop Score?
The Bishop Score is just one tool to see who would be the best candidate for a medical induction. Baby’s position can be a cause for a low Bishop score as women near 42 weeks, so it’s important to work with your care provider and doula to help get baby in the optimal position. Women also efface and dilate at different rates, so don’t get upset if you have a lower score early on; give yourself some time if you and baby are healthy.
The Bishop Score can help you make the best decisions for you and your baby. If you both are healthy, you will want to be sure to have a high Bishop Score before considering induction. But if you have a high Bishop Score and are healthy, you may want to wait since labor is likely to happen on its own. If there is no medical concern, waiting for baby to come in his or her timing definitely has its benefits. Weight the benefits and risks of induction and of waiting, and then do what you feel is best for you; it is your body and your baby!
The Bishop Score can help you make the best decisions for you and your baby. If you both are healthy, you will want to be sure to have a high Bishop Score before considering induction. But if you have a high Bishop Score and are healthy, you may want to wait since labor is likely to happen on its own. If there is no medical concern, waiting for baby to come in his or her timing definitely has its benefits. Weight the benefits and risks of induction and of waiting, and then do what you feel is best for you; it is your body and your baby!
