• Assessing cervical readiness for labor in term pregnancies
• Predicting the likelihood of successful vaginal delivery following induction of labor
• Determining whether cervical ripening agents (e.g., prostaglandins) are needed prior to oxytocin administration

"Call PEDS For Parturition": Cervical Position, Effacement, Dilation, Softness (Consistency), and Fetal Station.

• Cervical length via ultrasound < 25-30mm is equivalent to a "favorable" Bishop score.
• A low score (<6) does not mean a vaginal delivery is impossible; it simply means the induction will take longer (frequently >24 hours) and likely requires ripening.
• The digital exam should be performed between contractions for the most accurate assessment of station and dilation.

• High inter-observer variability (±1 cm difference in dilation/station is common).
• Poor correlation with successful induction in obese patients (BMI >30).
• Does not account for fetal weight or position (occiput posterior/transverse).

• High probability of successful vaginal delivery with induction
• Cervical ripening agents are generally unnecessary
• Induction of labor using oxytocin and/or amniotomy is appropriate

• Cervical ripening is indicated prior to standard labor induction
• Consider mechanical methods (e.g., Foley balloon catheter)
• Consider pharmacological methods (e.g., prostaglandins like misoprostol or dinoprostone)
• Re-assess the Bishop score after the ripening intervention

Developed by Dr. Edward Bishop in 1964. He sought to create a standardized point system to replace subjective clinical intuition when determining if a woman was ready for elective induction of labor.