Between 1989 and 1997, the percentage of induced labors in the United States doubled, according to the National Center for Health Statistics.
Before induction, the cervix should be assessed for position, effacement, dilatation and consistency. Also, the baby's engagement should be checked. Bishop's score can be ascertained by assigning points to the parameters of readiness. The higher the score, the more successful the induction is likely to be. The theory is that as a mother progresses to a higher and higher score, the more "ripe" the cervix and the more "inducible" she is.
Although this is an attempt at objectivity, the care provider still makes a rather subjective assessment of the cervix. That is, she is still making a judgment that may differ from another practitioner.
Induction should not be attempted unless a mother has a favorable Bishop's score, although she may be given misoprostel, cytotec or prostaglandin gel to help ripen the cervix and improve the score. A score of five or less is said to be "unfavorable." If induction is indicated, the mother would be a candidate for a cervical ripening agent. These are usually introduced one or two nights before the planned induction.
A score of eight or nine would indicate that the cervix was very ripe and induction would have a high probability of being successful.
As with any obstetrical intervention, it is wise to induce labor only when medically indicated. If you are scheduled for induction of labor, ask your provider for the indication and the risks associated with the procedure, as well as the potential benefits.
| Cervix | Score | |||
| 0 | 1 | 2 | 3 | |
| Position | Posterior | Midposition | Anterior | Anterior |
| Consistency | Firm | Medium | Soft | Soft |
| Effacement (%) | 0-30 | 40-50 | 60-70 | >80 |
| Dilation (cm) | Closed | 1-2 | 3-4 | >5 |
| Station | -3 | -2 | -1 | +1, +2 |
