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Bishop score (pelvic score for induction)

Also called Bishop index, cervical score, pre-induction cervical assessment

Five-item vaginal-examination score (0–13) of cervical readiness, used to choose the method of induction of labour.

Dilatation
Effacement
Station of the head
Consistency
Position of cervix

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Formula and scoring

Dilatation 0/1/2/3 (closed, 1–2, 3–4, ≥5 cm); effacement 0/1/2/3 (0–30, 40–50, 60–70, ≥80%); station 0/1/2/3 (−3, −2, −1/0, +1/+2); consistency 0/1/2 (firm, medium, soft); position 0/1/2 (posterior, mid, anterior). Total 0–13.

Exam and ward pearls

  • Dilatation, effacement and station score 0–3; consistency and position score 0–2 — hence the maximum of 13.
  • The modified (Calder) Bishop score replaces effacement with cervical length in cm; use your unit's chart for its point bands.
  • NICE NG207 uses ≤6 vs >6 to choose between ripening agents and amniotomy + oxytocin.

When not to rely on it

  • Devised by Bishop in 1964 for elective induction; it predicts successful induction only modestly.
  • Subjective, with inter-observer variation; repeat by the same examiner where possible.

Source

  1. Bishop EH. Pelvic scoring for elective induction. Obstet Gynecol. 1964;24:266-8. PMID 14199536
  2. National Institute for Health and Care Excellence. Inducing labour (NG207). London: NICE; 2021. Recommendations 1.3.7–1.3.9 and "Terms used in this guideline". Link
  3. Sinha P, Gupta M, Meena S. Comparing transvaginal ultrasound measurements of cervical length to Bishop score in predicting cesarean section following induction of labor. Cureus. 2024;16:e54335 (Table 1 reproduces the Bishop point table). doi:10.7759/cureus.54335 · PMID 38500903

Formula and cut-offs checked against these sources on 8 Nov 2026. Educational tool for clinicians; it does not replace clinical judgement.

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