Sometimes predicting when a baby will be born can be tricky. If you have no idea, then this Bishop score calculator will come in handy. This tool quickly determines whether your body is ready for delivery, and if the induction of birth is possible. Even if the pregnancy is at-risk, our calculator indicates whether or not the labor is about to start early.
Can't wait for your baby to be born? Then you might like to learn a little about their future height.
Bishop score - briefly
The Bishop score estimates the preparedness of a woman's body for delivery. Of course, you may know the estimated due date, but that's only an estimate; you can only know if this is really the time a few days before labor.
This formula is based on five characteristics, three of which describe the cervix of the mother, and two that cover the baby's position within the womb. Points are assigned to each result, and the sum of all of the points is the Bishop score. It indicates whether there's a high probability of successful labor or, more importantly, if it can be induced.
In some clinics, there's a method of making the time and place of the birth more predictable - elective induction. It also shortens the time of the procedure and reduces pain. To make the final decision, that is whether labor should be induced, we need to calculate the Bishop score.
What does induce mean when it comes to labor?
If there is a risk to the baby or mother, a gynecologist may decide to perform a labor induction. This means to cause the delivery, either by using drugs or non-medical measures. Why might labor be induced?
- Post-term pregnancy, lasting longer than 42 weeks. If twins: beyond 38 weeks. With every other baby, e.g., triplets, quadruplets, the safe duration of the pregnancy shortens. However, such big pregnancies tend to be a result of an in-vitro fertilization and are rare after a natural conception.
- Intrauterine fetal growth restriction (IUGR).
- Some conditions, such as pre-eclampsia, diabetes, or hypertension, which put the mother's or baby's health at risk.
- If the birth doesn't start naturally after a premature rupturing of membranes.
- Overweight mother, which is why maintaining a healthy weight gain during pregnancy, is important.
Not all women can undergo elective induction. First, the pregnancy should be at least 36 weeks along. Younger babies are not mature enough to be born, and their delivery might lead to complications, a lower APGAR score, and a spell in the ICU. Second is multiparity - if the woman has given birth before, then the whole process is more predictable for both the physician and the mother; the duration, pain, and any condition that might make a natural birth complicated.
What does induce mean in detail? Among the drugs used for the induction of delivery you'll find:
- Intra-vaginal prostaglandins, such as misoprostol, which cause uterine contractions and effacement (thinning) of the cervix.
- Intravenous oxytocin, a hormone that naturally induces labor.
It's also recommended that you consider some non-pharmacological options, such as:
- Membrane sweep, a short procedure where the midwife or obstetrician puts a finger into the cervix. With a circular movement, they try to separate the sac surrounding your baby from the cervix.
- Artificial rupture of the membrane (amniotomy). However it's not conclusive yet whether or not an amniotomy alone facilitates the birth.
Station labor, cervical dilation, posterior position - a glossary
Cervical dilation - where the cervix opens up in preparation for birth. If you're not yet ready to give birth, then your cervix is not dilated at all. However, when the delivery is starting, dilation reaches up to 10 cm - the diameter of a bagel! While that may sound surprisingly big, this size is safe; it allows the baby's head to go through your vagina.
Cervical effacement - in non-medical words: the thinning of the cervix, often expressed as a percentage. During pregnancy, mucus closes the cervix. When the labor is about to begin, the mucus passes, and the cervix shortens and thins. In the final stage before delivery, it can be as thin as a sheet of paper.
Cervical consistency - how the cervix feels, i.e., is it soft or firm. This is determined via a manual examination.
Station labor - how far down your baby has moved. There are three main cut-off points: the head is at the entrance to the canal, it is at the level of the ischial spines, and, finally, the head is just above the opening.
- Position - the cephalic presentation of the baby in the womb. Throughout the whole pregnancy, the baby moves from side to side, often changing its position and rolling over. If the fetus ends up in the breech position and can't flip around, the gynecologist most likely will perform a c-section. However, the most common position is the cephalic position, which allows vaginal birth . The baby reaches it between the 32nd and 36th week of pregnancy: its head is towards the cervix, the face is towards the mother's back (anterior position), and its chin is to its chest. There may be some differences in the position of the face:
- In case it's towards the mother's back, we call it the anterior position
- If the face of the baby is turned towards the side (either hip of the mother), it's called a mid-position
- In case the baby's face looks towards mother's front, it's ironically called the posterior position. This makes it much harder for the baby to get through the pelvis, but sometimes it may happen that it will rotate during the birth.
Bishop score calculator
In our tool, we focus on the signs that indicate whether induction could be successful. For each answer, you get a certain number of points, provided in the brackets:
- Cervical dilation in centimeters:
- closed (0)
- 1-2 cm (1)
- 3-4 cm (2)
- more than 5 cm (3)
- Cervical effacement as a percentage:
- 0-30% (0)
- 40-50% (1)
- 60-70% (2)
- more than 80% (3)
- Cervical consistency assessed by the gynecologist:
- Firm (0)
- Moderately firm (1)
- Soft (2)
- Fetal station labor, the position of the fetal head with respect to the pelvic bones:
- -3, the baby has not reached the vaginal canal (0)
- -2 (1)
- -1 or 0, the baby's head has reached the ischial spines (2)
- +1 or +2, the baby's head is already at the end of the canal (3)
- Head position
- Posterior position (0)
- Mid-position (1)
- Anterior position (2)
After assessing all of the five factors, sum up the points to get the Bishop score.
If the score six or below, you probably won't go into labor in the following weeks. If induction is inevitable, the doctor might apply some cervical ripening agents. On the other hand, if the score is eight or more, you are expected to go into labor soon. If induction is necessary, it should be successful.
Bishop score calculator in practice
Now that we're familiar with the theory, let's practice it as an example. Cassy, a 32-year-old lawyer, is 37 weeks pregnant with her second kid. She's thrilled with the pregnancy and can't wait for the child to come - she's even calculated the baby's blood type! The problem is that Cassy has diabetes and has severe hypertension, ergo it is quite clear that labor should be promptly induced. However, is she eligible for a vaginal birth and a successful induction? What does induce mean in her case, is there a recommended method? The gynecologist is not so sure and, after a physical examination, decides to use our Bishop score calculator to count her score.
- Cervix dilation is 6 cm (3)
- Cervical effacement is a bit more than 60% (2)
- The cervix is moderately firm (1)
- The baby's head has just reached the ischial spines (2)
- The baby is in mid-position (1)
The total score is 9, so luckily she's just become eligible for labor induction; her cervix is ready for the birth.