Calculate the Bishop Score for cervical favorability and labor induction readiness. Assesses dilation, effacement, station, consistency, and position.
The Bishop Score Calculator evaluates cervical readiness for labor induction by assessing five components of cervical examination: dilation, effacement, station, consistency, and position. Developed by Dr. Edward Bishop in 1964, this scoring system remains the standard method for predicting the likelihood of successful labor induction.
Scores range from 0 to 13, with higher scores indicating a more favorable cervix. A Bishop score of 6 or greater is generally considered favorable, with induction success rates comparable to spontaneous labor. Scores below 6 indicate an unfavorable cervix where cervical ripening agents (prostaglandins, mechanical dilators) are typically recommended before oxytocin induction.
This calculator provides instant scoring with visual feedback on each component, helping obstetric providers make evidence-based decisions about induction timing, ripening agent selection, and patient counseling about expected induction duration and success probability. Check the example with realistic values before reporting. Use the steps shown to verify rounding and units. Cross-check this output using a known reference case.
Labor induction accounts for approximately 25% of all deliveries in the United States, making cervical assessment critical for safe and effective practice. The Bishop score helps predict induction success, guide cervical ripening decisions, and set appropriate expectations for patients and providers.
Using a standardized scoring system improves communication between providers, supports documentation, and ensures consistent practice in managing induction of labor.
Bishop Score = Dilation (0-3) + Effacement (0-3) + Station (0-3) + Consistency (0-2) + Position (0-2) Total Range: 0-13 Favorable: ≥ 6 (induction likely to succeed) Unfavorable: < 6 (cervical ripening recommended)
Result: 8/13 — Favorable
A cervix that is 3-4 cm dilated (2), 60-70% effaced (2), at station -2 (1), soft (2), and mid-position (1) scores 8/13, indicating a favorable cervix with high likelihood of successful induction.
Dr. Edward Bishop published his scoring system in 1964 to predict the success of elective labor induction. The system was remarkably simple yet effective, and over 60 years later remains the standard method for cervical assessment. While various modifications have been proposed, the original five-component system persists in clinical practice worldwide.
Contemporary induction of labor often involves a two-step approach for unfavorable cervices: first, cervical ripening to improve the Bishop score, followed by oxytocin augmentation. The ARRIVE trial (2018) demonstrated benefits of elective induction at 39 weeks in low-risk nulliparous women, increasing induction volumes and the importance of accurate cervical assessment.
The Bishop score has inter-examiner variability, particularly for subjective components like consistency and effacement. It does not account for body habitus, fetal size, pelvic dimensions, or indication for induction — all of which affect induction outcomes. Despite these limitations, no alternative assessment has replaced it in clinical practice.
A score of ≥6 is generally considered favorable for oxytocin induction. However, induction can be performed at any Bishop score when medically indicated — lower scores simply have higher rates of prolonged labor and cesarean delivery.
Options include prostaglandin E2 (dinoprostone), prostaglandin E1 (misoprostol), and mechanical methods (Foley catheter balloon, Cook cervical ripening balloon). Choice depends on clinical factors, contraindications, and institutional protocols.
The Bishop score has moderate predictive value for cesarean delivery. Low scores are associated with higher cesarean rates (approaching 50% for scores 0-3), while favorable scores have cesarean rates similar to spontaneous labor onset (10-15%).
Yes. Multiparous women generally have higher success rates at any given Bishop score compared to nulliparous women. Some clinicians use different thresholds for nulliparous (≥8) and multiparous (≥6) patients.
Cervical length by ultrasound has been studied as an adjunct or alternative to the Bishop score. Cervical length <25-30mm correlates with favorable induction outcomes. However, the digital exam remains standard practice.
The Bishop score should be assessed immediately before the decision to induce or upon admission for induction. Cervical status can change rapidly, so assessments performed days before may not reflect current conditions.