Bishop Score Calculator

Assess cervical favourability for labour induction using the Bishop scoring system.

Important Clinical Disclaimer: Bishop Score Calculator is intended for use by qualified healthcare professionals only. It is for educational and informational purposes and should not replace clinical judgement. Always interpret results alongside the full clinical picture and follow your local guidelines and protocols.
Cervical Assessment

Assess each component on vaginal examination:

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Additional Information (Optional)
About the Bishop Score
Background

The Bishop Score was developed by Dr Edward Bishop in 1964 as a way to predict whether induction of labour would be successful. It remains the most widely used method for assessing cervical favourability before induction.

The Five Components
Component 0 Points 1 Point 2 Points 3 Points
Dilation Closed 1-2 cm 3-4 cm ≥5 cm
Effacement 0-30% 40-50% 60-70% ≥80%
Station -3 -2 -1/0 +1/+2
Consistency Firm Medium Soft -
Position Posterior Central Anterior -
Interpretation
  • Score ≥8: Favourable cervix - high probability of successful vaginal delivery
  • Score 6-7: Intermediate - reasonable chance of success, consider cervical ripening
  • Score ≤5: Unfavourable cervix - cervical ripening recommended before induction
UK Practice (NICE Guidelines)

NICE recommends assessing the Bishop Score before induction. If the cervix is unfavourable (Bishop Score typically ≤6), cervical ripening with vaginal prostaglandins (PGE2) or a balloon catheter should be offered before amniotomy and oxytocin.

Frequently Asked Questions

The Bishop Score is a pre-labour scoring system used to assess the likelihood of successful induction of labour. It evaluates five components of cervical examination: dilation, effacement, station, consistency, and position. A higher score indicates a more favourable cervix for induction.

A Bishop Score of 8 or more is considered favourable and indicates a high likelihood of successful vaginal delivery following induction. Scores of 6-7 are intermediate, while scores below 6 suggest the cervix is unfavourable and cervical ripening agents may be needed before induction.

The Bishop Score is calculated by assigning points (0-2 or 0-3) for each of five cervical characteristics: dilation (0-3 points), effacement (0-3 points), station (0-3 points), consistency (0-2 points), and position (0-2 points). The maximum possible score is 13.

The Bishop Score is used before planned induction of labour to assess cervical readiness. It helps clinicians decide whether to proceed directly with induction or to use cervical ripening methods first. It's also used to counsel women about the likelihood of successful induction.
References
  1. Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-268. PMID: 14199536
  2. NICE Guideline NG207. Inducing labour. National Institute for Health and Care Excellence. 2021. NICE NG207
  3. RCOG Green-top Guideline. Induction of Labour at Term. Royal College of Obstetricians and Gynaecologists. RCOG Guidelines
  4. Laughon SK, Zhang J, Grewal J, et al. Induction of labor in a contemporary obstetric cohort. Am J Obstet Gynecol. 2012;206(6):486.e1-9. PMID: 22631865
Score Interpretation
≥8: Favourable

High success rate, proceed with induction

6-7: Intermediate

Consider cervical ripening

≤5: Unfavourable

Cervical ripening recommended

Cervical Ripening Options
Pharmacological
  • Dinoprostone (PGE2) - vaginal gel, tablet, or pessary
  • Misoprostol (PGE1) - oral or vaginal
Mechanical
  • Balloon catheter - Foley or double-balloon
  • Membrane sweeping - if membranes accessible
Parity Effect

Multiparous women generally have:

  • Higher success rates at same Bishop Score
  • Shorter induction-to-delivery interval
  • Lower caesarean section rates

Nulliparous women may need higher Bishop Score for equivalent success.

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Disclaimer

This calculator is provided for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

  • Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition.
  • Never disregard professional medical advice or delay seeking it because of information from this tool.
  • Clinical decision-making should always incorporate the full clinical context, patient preferences, and local protocols.
  • The creators of this tool accept no liability for decisions made based on its output.

If you are a patient: please discuss any results with your healthcare provider. This tool is designed for use by medical professionals and may not be appropriate for self-assessment.