What does a Bishop score mean before induction?

What does the evidence say about bishop score for labor induction?

1. ACOG describes the Bishop score as a 0-to-13 assessment, with a score below 6 suggesting the cervix may not yet be ready for labor. This is a planning tool. Ask which findings contributed to your score rather than interpreting the total as a pass-or-fail test. 1
2. The five components describe cervical dilation, effacement, position, consistency, and fetal station. Different versions and protocols use somewhat different thresholds. A score from an online calculator may not match the version your unit uses, especially when it substitutes cervical length for thinning. 2
3. In the ARRIVE trial, the cervical assessment was one part of studying a defined induction strategy in low-risk first pregnancies. A less favorable cervix did not make induction impossible. Trial outcomes are not a personal success percentage that can be calculated from the score alone. 3
4. Readiness before induction differs from progress after labor becomes established. Current labor guidance defines active labor using cervical dilation and evaluates a lack of progress with additional conditions. Do not use the original Bishop score to decide that an induction has failed several hours later. 4
5. If ripening is appropriate, the team may discuss a mechanical balloon or medication before other induction steps. Prior uterine surgery and the reason for delivery influence which methods can be offered. Request a plan that connects the score with the proposed next step and its alternatives. 1

When is a Bishop score useful for planning?

• First trimester. A Bishop score is not an early-pregnancy health or fertility score.
• Second trimester. Learn about induction methods if a delivery-timing decision is anticipated.
• Third trimester. Ask how the actual cervical findings affect ripening, monitoring, and the next reassessment.

Questions for your birth team