Bishop score and likelihood of successful induction

[showmorekindness]

Grateful for anyone's thoughts on whether I have this wrong (especially any midwives/doctors on here), or just any input from others who have been through induction.

From everything I have been reading, my understanding was that the higher your Bishop score the more likely induction is to be successful (essentially because you are already closer to going into labour pre-induction). I think I read somewhere that a Bishop score of 8+ is very favourable for induction, 6/7 it can go either way, and 5 or less is unfavourable.

I had a discussion with my MW about possibly declining drip induction (if it's due to dates only, no concerns about baby) in favour of c-section depending on what my Bishop score is at the time. I was a bit surprised to be told that the Bishop score doesn't really mean anything and isn't an indicator of whether or not induction will be successful.

Have I got this wrong?

I appreciate the statistics are an average or based on studies and therefore can't be applied to every single woman, but I thought the above was generally considered to be the case.

For those who have had successful or unsuccessful drip induction, do you know what your Bishop score was beforehand (I.e. after pessary/gel if you had one but before the drip)?

TIA

When I was induced 2 years ago my bishop score started at 0. I then had a pessary and after 6 hours it went to 7-8. This was enough to break my waters and they said if labour continued to progress (I was having mild contractions) then I could avoid the drip.
Although my contractions felt really strong I had no progression of dilation after 2-3 hours. I agreed to have the drip but also an epidural. I then slept through the rest of my labour (woken up for examinations) and was fully dilated 10 hours later. Fully rested and ready to push!
I appreciate not everyone has the same experience but mine was a positive one!

I’m a midwife. The problem (not insurmountable!) I see with your plan to request c/s if BS

With my 4th baby and 4th induction they checked my BS 6 hours after the first pessary, it was still 1 (was 1 before I got pregnant!) had the next pessary and had delivered within 4 hours with an official labour of 2 minutes.

My shortest induction was only one pessary, the long two took 3 pessaries and ARM but all my deliveries were straightforward and unassisted. As has been said you just don't know. My issue was always getting me into established labour once I reached that point it went fairly quickly.

My drip induction was also positive. I had a Bishop score of 0 before the pessary, and a score of 4 after my waters were broken. There were zero contractions up until the drip started, and took a while to get going. Diamorphine meant I got some sleep between contractions from 5-9cm and had a regular vaginal delivery in the end.

My anecdotal and personal experience a bishops score is not a reliable indicator of how your body will respond to induction. I was 3 at 37 weeks. Had one propess pessary and within 12 hours baby was born.

Thanks everyone

Thank you for your input @SwayingInTime I hadn't thought about it that way so it's given me something to think about. I'm just not sure I'm willing to accept the risks of the drip if the pessary doesn't at least get me closer to labour, but it's been helpful to hear the positive stories from others!

I didn't put on mine that I was induced for being over due so even when I was 42 weeks and 42 +3 my bishops score was still only 1 🤦🏼‍♀️

What are your reasons for refusing the drip if you don't mind me asking? A lot of women being induced need it and have successful vaginal births without needing a caesarean. However, if they did not have the drip they would have had a failed induction and needed the caesarean.

My 1st induction i only had pessaries and ARM. My 2nd induction i needed the drip and contractions were very strong but i delivered within a few hours, no tear, felt amazing after. You can always have a conversation with a doctor at any stage if you feel things are not going in the direction you want but i would not rule out the drip full stop.

Of course BS has a clinical significance with regard to the likelihood of successful induction. That midwife is gaslighting you because she doesn’t like that you called her out on it! I have absolutely no idea what perverse incentive makes the NHS push women into inductions that last for several days and predictably end in EMCS and multiple interventions. Presumably they get black marks for ELCS that they don’t get for EMCS? I would defo use my BS to help make an INFORMED choice about induction.