The Bishop score combines dilatation, effacement, station, consistency and position. A low score marks an unfavourable cervix, where a ripening step — mechanical or pharmacological — usually comes before oxytocin. A favourable cervix can often go straight to amniotomy and oxytocin.
Record the score at the start and at each reassessment. It makes the decision to move from ripening to oxytocin, or to review the plan, explicit and auditable.
- Record a Bishop score before any induction.
- An unfavourable cervix usually needs ripening before oxytocin.
- Reassess and record the score before each change of method.
- Document why a method was chosen so the next shift can follow the plan.
Why it matters
The choice of ripening agent only makes sense against a recorded starting cervix.
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