“How likely is it that you go into labor spontaneously without needing a medical induction?”
Well, one factor which could give you a rough idea is your Bishop score which is a measure
for how ready your cervix is for labor.
Yes, so, in this video, we are first going to explain what exactly the Bishop score is!
And then we are going to calculate your own Bishop score based on the 5 factors the Bishop score
comprises. Yes!
And then at the end of this video, we are also gonna tell you what your own Bishop score
means and how you can improve the score in the hopes to increase your chances of a spontaneous
labor.
This is Nathalie, a pregnancy and birth consultant and TCM therapist, and that’s Mathias a
researcher and science geek and we are here to help mommies and their babies naturally
and science-based!
So, let’s talk about your Bishop score!
Alright, so first of all, the Bishop score basically gives you a rough idea how likely
it is that you will have a spontaneous labor from the point of view of your cervix.
But it’s important to note that it is only a snapshot of your current situation.
Yes.
On top of that, the Bishop score also gives you a rough idea about how likely it is that
a medical induction will be a success in case you do not go into labor spontaneously.
Because remember, medical labor induction does not always work which means that sometimes,
women end up in a C-sections, right?
In so far, the Bishop score essentially tells you how likely it is that you will have
a vaginal delivery, either a spontaneous one or a successfully medically induced one.
Right!
With that said, let us now quickly walk you through the 5 factors that the Bishop score comprises
and how each factor either lowers or increases your score.
Yes! On top of that, we are also going to tell you how to calculate your own Bishop score.
But don’t worry about the calculation because we are going to make use of some free software
which will do the calculations for us.
What you do need though, is the current status of the 5 factors that we are going to discuss
now.
If you don’t have this information, you might have to ask your provider.
Weeks before labor begins, your cervix is posterior which means that it points toward
your back.
But as you are getting closer to your due date, your cervix gradually moves into a mid-point
position and eventually into an anterior position which means that it now points toward your
front. Yes!
So, ask your provider, what is the current position of your cervix!
If it's already in an anterior position, you add 2 points to your Bishop score.
If it is mid-point, you can add 1 point and if it is still posterior, you don’t add any
points.
As you probably know, throughout your pregnancy, your cervix has a firm consistency.
But because your cervix needs to undergo some changes in order for your baby to be able
to move into the birth canal, your cervix is going to soften.
And since a soft cervix is really the basis for any further changes to your cervix, it
is obviously a major component of the Bishop score. Yes.
So, please ask your provider about the consistency of your cervix.
If it is still firm, you don’t add any points.
If it is moderately firm, you can add one point.
And if it is already soft, you can add 2 points.
Once your cervix is soft, it is then going to shorten which is called effacement.
If your cervix is not effaced at all, then it is normally some 4 cm long.
So, if your cervix is still longer than 3cm, then you don’t add any points.
If it is between 2 and 3 cm, you add one point.
If it is between 1 and 2 cm, you add 2 points and for shorter cervixes, you add 3 points.
Yes.
And please don’t worry if that was too fast for you or too confusing.
You can find more information about cervical effacement and how many points to add in the
description below this video!
Dilation means that your cervix is going to open up so that your baby can move into the
birth canal.
As a result, dilation obviously increases your Bishop score, right?
So, if you are between 1 and 2 cm dilated, you can add 1 point.
If you are between 3 and 4cm dilated, you can add 2 points.
And everything above 5cm means that you can add 3 points.
Yes.
But of course, this would normally mean that you are already feeling very strong contractions
because you are in labor, right?
And in that case (>=5cm dilated), you obviously don’t need to worry about the Bishop score anymore.
Baby’s engagement basically tells you how deep your baby is in your pelvis.
In fact, the location of the so-called presenting part, which is the top of your baby’s head
within in your pelvis, is measured in stations.
We talk about this in more detail in one of our other videos which you can find in the
description below this video but basically a station is measured in centimeters in relation
to the so-called ischial spines which you can see here.
Yes.
So, if your baby is engaged, the top of your baby’s head would be at station 0 although
some people also say that station -1 qualifies as engagement.
So, if your provider tells you that your baby is engaged, which means station -1 or 0, then
you add 2 points to your Bishop score.
If your baby is even deeper in your pelvis, you can add 3 points.
Yes.
If, on the other hand, your baby is not yet engaged but is currently at station -2, you
would add 1 point to your Bishop score.
And if your baby is still higher than that, you don’t add any points!
Right, so those were the 5 factors that the Bishop score comprises and which will give you a
score between 0 and 13. Right!
So, if you have the information about the status of those 5 factors already, then you can
either calculate your Bishop score manually, or you can use some software that does the
calculations for you for free.
You can find more information on how to find this software in the description below this
video.
However, we recommend watching this video til the end first. Yes!
Okay, so, before we talk about how to interpret the results, let us briefly explain 3 important
things: First of all, as mentioned before, the Bishop score is only a snapshot of your
current situation.
So, don’t be discouraged if your own score is very low.
This can change really, really fast.
Yes.
We have met many women whose Bishop score changed considerably within a few days only
and they did go into labor spontaneously despite the initial low score.
And don't worry, we are going to tell you exactly what you can try
to increase your own score!
So that’s one thing.
The other thing is that, if you have given birth to at least one baby in the past already,
then you have even less reason to worry if your Bishop score is low.
And that’s because for such women, the whole labor preparation process of their body and
also labor itself tends to be a bit different but most importantly much faster, right?
Yes.
For example: they often go into labor although their baby has not yet engaged.
In first time moms on the other hand, the baby normally drops weeks before they go into
labor.
Because of that, what we do at the clinic is, we add one point to the Bishop score if
a woman has given birth to at least one baby in the past already.
You can do this too, but don’t overcomplicate things! Yes!
And third, please also keep in mind that the Bishop score only looks at your cervix.
And while this gives us some great insights, it’s important to note that there are also
other things which have a role to play when it comes to going into labor.
For example: if your stress levels are really high, it may be very difficult for you to
go into labor even when your Bishop score is high, right?
Yes! But enough with the talking.
Let us now look at how to interpret your Bishop score.
A Bishop score up to 5 points tells you that you currently have an unfavorable cervix.
So, at the moment, it looks like that your body does not have plans to go into
labor.
And so, if, for whatever reason, you need to go into labor as fast as possible, then
a medical induction may be required if you still want to have a vaginal delivery.
But again, this can change very quickly, right?
Yes.
So, if a woman is at least 37 weeks pregnant and her score is below 6, then we would normally
primarily focus on tools to help soften her cervix.
For example: by eating dates or by acupressure.
Another great tool that we use very often in such a scenario are exercises, particularly
exercises on a birthing ball.
Yes.
And if a woman is at least 38 weeks pregnant, we would also add reflexology.
In other words, we would apply tools which are intended to help her body get to a
point where a spontaneous labor is more likely and also, to a point where labor induction
is more likely to work, right? Yes!
And by the way, we explain how to apply acupressure and reflexology and how to do exercises on a birthing
ball in other videos which you can find in the description below this video.
If your Bishop score is between 6 and 7 points, then it is considered an “intermediate result”.
And with such a score, unfortunately, we cannot really say how likely it is that you go into
labor spontaneously or not.
And we can also not say how likely an induction is going to work or not, right?
Right!
However, please note that if your score is 6 or 7 then, it’s already a very good score.
Your cervix is probably already anterior and soft.
Your baby has probably dropped by now.
And you probably already experience some effacement, maybe even some dilation to some degree.
Yes.
And so, in such a situation, what we wanna do to increase the Bishop score even further
is help the body get contractions started or, if a woman already had some contractions,
we would try to intensify them.
This may not always help the woman get labor started.
But if she gets at least some contractions or more intense contractions, it can
be an important basis for the next step, right?
Exactly!
And in order to help her with that, we would normally try nipple stimulation while continuing
with exercises, particularly exercises on a birth ball.
Reflexology can also work really well, and another thing is acupuncture particularly,
if stress is currently a big issue in your life.
Keep in mind though, it should really be acupuncture at this point and not acupressure because
at the clinic we see that acupuncture gives us better results in such cases.
A Bishop score above 7 normally means that a spontaneous labor is very likely and that
it is unlikely that a woman will need a medical induction.
And please note that it IS possible to reach a score above 7 without being dilated, right?
And I say this because we know that many women panic if their cervix is still closed at some
point, right?
However, once labor has started, your contractions will take care of your dilation, so, don’t
worry about it! Exactly!
So, if, for whatever reason a woman with a Bishop score of above 7 is under time pressure
and cannot wait for her body to start labor on its own, then natural labor induction is
what we could try if approved by her provider.
And we would do that basically with the same tools as before: exercises, maybe acupuncture
if that’s an option, but most importantly, nipple stimulation.
And in addition, there is another tool which could help.
And that’s Castor oil, again, if her doctor approves it.
Yes.
But please keep in mind that there is never a guarantee that these things do work because
as we mentioned before, there are also other factors which play a role when it comes to
going into labor, apart from your cervix, right?
And so, we can only tell you what works best for most women in the hopes that it will help
other women too.
So, if you have not done so already, you can now calculate your own Bishop score, if you
like!
And then watch our other videos which are intended to help you increase your Bishop
score.
You can find the link to those videos as well as further guidance on how to calculate your
own Bishop score as well as which free software to use in the description below this video!
Right!
We really hope that you have found this video helpful!
If you did find our video helpful, we would be super grateful if you could leave us a
like or even a comment in the comment section below!
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