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Childbirth

Share experiences and get support around labour, birth and recovery.

Bishops score

15 replies

VictorianSqualor · 28/03/2008 10:31

So, I'm now 38+3, and am having a CS on the 9th if nothing has kicked in by then.
Should I ask the midwife to do an internal exam and tell me my bishops score before I go down to surgery?
How reliable is the bishops score?

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carmenelectra · 28/03/2008 16:30

I would def ask for a Bishops score!

nOT sure on exact figures for reliabilty but i would say in my own experience they are pretty reliable!

Cant do any harm can it?!

VictorianSqualor · 28/03/2008 16:33

See that's what I was thinking (the no harm angle) if they tell me it's favourable I think I'll push for a later date for the CS.
At least if they say I'm not likely to go into labour soon then I won't kick myself for not waiting another couple of days.
I just think so few women have their babies by their due date that it's not looking likely mine will come before then.

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CarGirl · 28/03/2008 16:35

Why are you having a CS????? With my 4th I went from a BS of 1 to having given birth (after a 2nd induction pessary) within 4 hours!

PortAndLemon · 28/03/2008 16:41

VS has two prior CS (so can't be induced) and has specific placental issues with this baby that make it potentially dangerous to go over term (ideally they wanted her to deliver early, but as she's so committed to VBAC have scheduled the c/s for 40 weeks instead).

VictorianSqualor · 28/03/2008 16:41

There are complications with ym placenta cargirl, bascally the blood flow is limited.
My cons wanted baby out at 38weeks but we discussed it and agreed to wait til 40weeks with monitoring but now I'm wishing I'd still said no.
I have my pre-section meeting next week, I'll discuss it with them then I think.

OP posts:
VictorianSqualor · 28/03/2008 16:41

lol PAL, How come you can say my history better than me?

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carmenelectra · 28/03/2008 16:52

Absolutely VS. At least you will know and if you are a'bit' favourable and its safe to do so then you can hang on a bit, especially if you are keen for a normal delivery.

I would defintely, definitely if it were me

VictorianSqualor · 28/03/2008 17:31

Thanks Carmen.

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carmenelectra · 28/03/2008 17:55

No probs. Best of luck

CarGirl · 28/03/2008 19:49

I'm back now!!! I was just wanting to say I'm one of those people who even waiting 16 days past term I didn't have a positive bishops score!

BetsyBoop · 28/03/2008 22:24

VS

Biship score is definitely a good way of seeing if things have started & if so how much "started" they are - what it can't (obviously) tell you is if things are going to get started in a couple of hours or how long from then until delivery (Although the better the score the more likely things will get moving soon)

They were quite happy to check the readiness (or rather NOT-readiness ) of my cervix a number of times on the run up to my wanting-a-VBAC-but-booked-an-ElC/S-for-10-days-over-just-in-case C/S, unfortunately for me nothing doing, but there's no harm in checking. They even checked me on the morning of my elective at 40+10, bless them, but still nothing doing, as in a zero score (I think that's the lowest you get?) - cervix high, firm, anterior, long, closed, nothing doing - didn't get more conclusive than that, that DS had no intentions of budging any time soon

carmenelectra · 29/03/2008 00:03

I realy wanted to know mine prior to an induction as they had booked me in the next day without even examining me to check i was 'favourable'.

Thankfully i got examined in the end!

hertsnessex · 29/03/2008 00:35

Heres some info on Bishops Score:

Bishops Score

A Bishop's Score refers to a group of measurements used to determine whether a woman may have a successful vaginal delivery and whether labor ought to be induced. Bishop's Score is based on station, dilation, effacement, position and consistency.
Station is a term used to describe the descent of the baby into the pelvis. An imaginary line is drawn between the two bones in the pelvis (known as ischial spines). This is the "zero" line, and when the baby reaches this line it is considered to be in "zero station." When the baby is above this imaginary line it is in a minus station. When the baby is below, it is in a "plus" station. Stations are measured from -5 at the pelvic inlet to +4 at the pelvic outlet.
Dilation is measured in centimetres, from 0 to 10. Your cervix is fully open and you should be able to push when it is dilated to 10 centimetres. Occasionally, a physician will measure dilation in "fingers." Dilation often begins days or weeks before labor actually begins. At first, the progress may be very slow. Some women may be dilated 2 to 3 centimetres long before labor. Once active labor begins, you will begin to dilate more quickly.
Effacement refers to the softening and thinning of the cervix. You won't feel this happening; it may only be measure with a vaginal exam. Effacement is measured in percent. When your cervix is normal, it is considered to be 0% effaced. When you're 50% effaced, your cervix is half its original thickness. When your cervix is 100% effaced it is completely thinned out and you are ready for vaginal delivery.
Position refers to the positioning of the cervix. If the cervix faces front (anterior) it is more favorable, while posterior is less favorable.
Consistency of the cervix is measured on a scale of firmness from firm to soft. The softer the cervix is, the better the chance of vaginal delivery.
To ensure your own induction's success rate, inquire about your Bishop's score or better yet learn each part of the score and figure it out for yourself. The unfortunate reality I have seen lately is inductions with scores as low as 2 which makes induction very difficult and success rates low. Induction with low Bishops scores decreases a woman's coping ability with the increased pain of induction and the increased length of labour. This can be combined with AROM (artificial rupture of membranes) to supposedly increase the success rate early in the induction, but in fact this far too often leads to cesarean births as ruptured membranes increases the chance of infection for both mother and baby. Make informed decisions for both you and your baby!

Score Dilatation Effacement Station Position Consistency
0 closed 0 ? 30% -3 posterior firm
1 1-2 cm 40 -50% -2 mid-position moderately firm
2 3-4 cm 60 -70% -1,0 anterior soft
3 5+ cm 80+% +1,+2
A point is added to the score for each of the following:
Pre-eclampsia
Each prior vaginal delivery
A point is subtracted from the score for:
Postdates pregnancy
Nulliparity
Premature or prolonged rupture of membranes
Interpretation
cesarean rates: first time mothers women with past vag. del
scores of 0 ? 3: 45% 7.7%
scores of 4 - 6: 10% 3.9%
scores of 7 - 10: 1.4% .9%
Induction is generally attempted when a mother has a favorable Bishop's score. A mother 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." A score of eight or nine would indicate that the cervix was very ripe and induction would have a high probability of being successful.

i am not sure the format will read correctly as i am taking this from information i would give to clients in a word doc.

hope it helps.

x

VictorianSqualor · 29/03/2008 11:07

Thankyou everyone, I'm going to discuss it with them when I go for my pre-section thingy and tell them I want examining first.

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carmenelectra · 29/03/2008 11:26

YES ask for it at pre op, perfect chance then.

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