The Bishop’s score was originally developed to predict the likelihood of a

woman entering labor naturally in the near future. A woman with a low score
of 1 would not expected go into labor for about 3 weeks. A woman with a
higher score score of 10 could be expected to go into labor within a few
days.

Although the Bishop’s score was originally used to evaluate the likelihood of
vaginal delivery in women who have given birth before (multiparous) it is also
now used for women who have never given birth (nulliparous) who are being
considered for induction of labor.

If the Bishop score is 8 or greater the chances of having a vaginal

delivery are good and the cervix is said to be favorable or "ripe" for
induction. If the Bishop score is 6 or less the chances of having a
vaginal delivery are low and the cervix is said to be unfavorable or
"unripe" for induction.

A simplified Bishop score using only dilation, station and effacement may be
as predictive of successful induction as the original full Bishop score. A
simplified Bishop score of 5 had a similar predictive value of having a
successful vaginal delivery as an original Bishop score of greater than 8.

How The Points Are Assigned

Dilatation (Dilation)
The most important element of the Bishop score is dilatation.
Dilatation is the distance the cervix is opened measured in
centimeters (cm) . For reference a penny is about 2 cm across.
Points are given from 0 to a maximum of 3 points for a cervix dilated to 6 cm
or greater.
Effacement

Effacement (also called shortening or thinning) is reported as a percentage

from zero percent (normal length cervix) to 100% or complete (paper thin
cervix). Points are given from 0 to a maximum of 3 points for a cervix effaced
to 80 % or greater.

Image credit: National Institutes of Health 2011.

Station

Station is the position of the baby's head

relative to the bony projections of the
lower pelvis called the ischial spines.
When the baby's head is at 0 station its
head is even with the ischial spines.
Stations divides the pelvis above and
below the ischial spines into 3rds
Negative numbers indicate that the head
is above the ischial spines. Positive
numbers indicate its head is below the
ischial spines.

Points are given from 0 to a maximum of (c) LifeART / www.fotosearch.com Stock Photography
3 points for a station of 1 + or 2+.

In 1988, the American College of Obstetricians and Gynecologists redefined

station as the level of the leading bony point of the fetal head at or below the
level of the maternal ischial spines measured in centimeters (0–5 cm).

Consistency

The texture of the cervix on examination.

Firm : The cervix feels hard and rubbery .
Medium: The cervix feels compressible but not soft
Soft : The cervix feels mushy

Position

The position of the cervix relative to the fetal

head and maternal pelvis