How it's calculated
Five components of cervical examination (dilation, effacement, station, consistency, position) are each scored, for a total of 0-13, estimating how favourable the cervix is for labour induction.
Score interpretation
| Score | Interpretation |
|---|---|
| ≤5 | Unfavourable — ripening agent often considered |
| 6-7 | Intermediate |
| ≥8 | Favourable — similar success to spontaneous labour |
Clinical use
- Used before elective or medically indicated labour induction to estimate the likelihood of a successful vaginal delivery and to guide the choice of induction method.
- A low score (unfavourable cervix) often prompts use of a cervical ripening agent (e.g. prostaglandins, mechanical dilation) before oxytocin induction.
- A score of 8 or more suggests a favourable cervix, with induction success rates approaching those of spontaneous labour.
- A modified version incorporating parity, prior caesarean, and other factors also exists, but the classic five-component score remains the most widely used bedside version.
Frequently asked questions
What is the Bishop Score used for?
It estimates how favourable a woman's cervix is for labour induction, based on five components of the cervical exam, helping guide the choice and timing of induction method.
What score is considered favourable?
A score of 8 or higher is generally considered favourable, with induction success rates similar to spontaneous labour; scores of 6 or below are considered unfavourable.
What happens with an unfavourable (low) score?
A cervical ripening agent — such as a prostaglandin or a mechanical method — is often used first to improve cervical favourability before proceeding with oxytocin induction.
Does a low Bishop Score mean induction cannot proceed?
No — it means induction is less likely to succeed without cervical ripening first; it does not rule out induction altogether.
References
- Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-268.
- ACOG Practice Bulletin No. 107: Induction of Labor. Obstet Gynecol. 2009;114(2):386-397.