9.10.2008

Considering Induction? Refer to Your Bishop...

In the mid 1960s, the Bishop Scoring (Bishop, E. Pelvic scoring for elective induction. Obstetrics and Gynecology 24(2), 266-268) method was introduced as a means of evaluating the cervix in relationship to successful induction. This scoring system attempts to predict success of induction by assessing five factors: position of the cervix in relation to the vagina, cervical consistency, dilation, effacement and station of the presenting part. The higher the score, the higher rate of success of the induction. A score less than five indicates an unfavorable cervix for induction. Some texts also reference the Burnett Scale* which assesses approximately the same factors.

A score of 5 or less suggests that labor is unlikely to start without induction. A score of 9 or more indicates that labor will most likely commence spontaneously. A low Bishop's score often indicates that induction is unlikely to be successful. Some sources indicate that only a score of 8 or greater is reliably predictive of a successful induction.

Although some care providers will attempt to improve scoring through cervical ripening agents (Cervadil, Cytotec, or Foley Catheters) before induction (Pitocin, AROM, etc…), that will only improve ONE of the many assessing factors.

Below, you will find the Bishop Scoring chart.

Something to keep in mind; if you are attempting to see how favorable your body is for successful induction, I would recommend NOT asking your doc for your Bishop score, but ask, instead, for your dilation, effacement, station of baby, position of baby, and consistency of your cervix - so that later you can assess your OWN Bishop's Score. Many doctors will give a skewed score or refuse to give it outright. This will alleviate that issue.

Once you add up your points, this is how to interpret your score:
  • 0-4 points = 45-50% failure to induce successfully
  • 5-9 points = 10% failures rate
  • 10-13 points = 1% failure rate
* Here is a great link for the 'revised chart'. Just one more way to be informed and make informed decisions on your health care.

3 comments:

jill said...

Nicole, can you explain what you mean by a successful induction?

Nicole D said...

A successful induction would be an induction that results in a labor which effectively brings the cervix to complete dilation and allows for baby to move through the pelvis of mom and also not cause medical complications to mom or baby as a result of the induction - resulting in a vaginal birth.

Conversely, an unsuccessful induction would result in insufficient, stalled, or incomplete dilation, inability for baby to move down the pelvis and through the birth canal; or a medical complication as a result of the induction... which would result in a cesarean/surgical birth.

jill said...

Thank you!

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