What is a Bishop score?
You may hear your nurse, midwife, or doctor mention your Bishop score before or during an induction. It's a tool used to describe how ready — or favorable — your cervix and baby's position are for induction.
1. Dilation
How open is your cervix?
2. Effacement
How thin has your cervix become?
3. Cervical consistency
Does your cervix feel firm, medium, or soft?
4. Cervical position
Is your cervix pointing toward your back (posterior), somewhere in the middle, or toward the front (anterior)?
5. Fetal station
How low is your baby's head in your pelvis?
Each category receives points. Those points are added together to create your Bishop score.
What do the numbers mean?
In general, a higher Bishop score means the cervix is more favorable for induction. A score around 8 or higher usually suggests the cervix is quite favorable, and the likelihood of induction resulting in vaginal birth is similar to someone who begins labor spontaneously.
A lower score doesn't mean your induction won't work. It usually means your cervix may benefit from cervical ripening first, before moving on to methods primarily aimed at creating stronger contractions, such as Pitocin. That's an important distinction.
A Bishop score isn't a grade your body is receiving, and a low number doesn't mean your body is "failing." It is simply information that can help guide which induction tool makes the most sense at that particular moment.
How the score is calculated
| Finding | 0 pts | 1 pt | 2 pts | 3 pts |
|---|---|---|---|---|
| Dilation | Closed | 1–2 cm | 3–4 cm | 5+ cm |
| Effacement | 0–30% | 40–50% | 60–70% | 80%+ |
| Baby's station | −3 | −2 | −1 or 0 | +1 or +2 |
| Cervical consistency | Firm | Medium | Soft | — |
| Cervical position | Posterior | Mid-position | Anterior | — |
The maximum traditional Bishop score is 13. Consistency and position max out at 2 points each.
Worked example
Imagine you're told: 2 cm dilated · 50% effaced · −2 station · medium consistency · posterior cervix.
- Dilation (1–2 cm)1
- Effacement (40–50%)1
- Baby's station (−2)1
- Cervical consistency (Medium)1
- Cervical position (Posterior)0
Total Bishop score: 4 / 13
That tells us something very different from simply hearing, "You're 2 centimeters." Dilation is only one piece of the picture.
🔎 Bishop score calculator
Tap the five findings from your most recent cervical exam.
Your Bishop score
0 / 13
Select all five findings for a complete score. Unselected findings currently count as 0.
0–5 · Less favorable cervix
Your cervix may still need some ripening. Your care team may discuss options such as medication or a cervical balloon before — or sometimes alongside — other induction methods.
What might come next?
- Cervical ripening is often the first step: misoprostol, dinoprostone, and/or a cervical (Foley) balloon.
- Ripening can take hours, and a repeat exam afterward may show change in softness, position, and effacement even if the centimeters barely move.
- Pitocin is usually more effective once the cervix has ripened, so starting it first is not always the fastest route.
- A low score is information about which tool fits right now — not a prediction that induction will fail.
General education about how induction tools are usually sequenced — your care team decides with you based on your whole picture.
After your next cervical exam, come back, save this one as the previous exam, and enter the new findings to see how much changed.
Why does the Bishop score matter during an induction?
This is where the pieces of an induction start fitting together. If your Bishop score is low, your provider may recommend beginning with cervical ripening, such as misoprostol and/or a cervical balloon. If your cervix is already very favorable, cervical ripening may not be necessary — depending on your situation, your care team may discuss Pitocin, breaking your water, waiting to see whether contractions develop, or another approach.
And your Bishop score can change. After several hours of cervical ripening, you might only go from 1 cm to 2 cm and think: "Nothing happened." But maybe your cervix also changed from firm to soft, moved from posterior to anterior, became significantly more effaced, and baby's head moved lower. That's progress. The centimeter number doesn't tell the whole story.
- Induction methods explained →Misoprostol, dinoprostone, Foley balloon, amniotomy, and Pitocin — benefits, risks, and alternatives for each.
- Questions to ask before Pitocin →Build a question list for the conversation about what comes next.
- The three numbers from a cervical check →Dilation, effacement, and station with visuals and the physiology behind each.
- Active vs. physiological management →Where you have a choice, and how to weigh each option with your team.
Remember
- Your Bishop score doesn't predict exactly how your birth will unfold.
- It doesn't tell you how long your induction will take.
- It doesn't tell you whether you'll need an epidural.
- A low Bishop score does not mean you can't have a vaginal birth.
Think of it as a snapshot: where are my cervix and baby right now, and what information does that give us about the next step?
Sources
- Practice Bulletin 107: Induction of Labor — ACOG
- WHO recommendations: induction of labour at or beyond term — World Health Organization
- Inducing Labour (NG207) — NICE
- Evidence on: Inducing Labor — Evidence Based Birth
The Bishop score is a clinical assessment tool, not a diagnosis or a guarantee of induction success. Your provider may use a modified Bishop score or slightly different scoring criteria. Educational only — not a substitute for your care team's judgment about your specific situation.