Bishop score = dilation (0–3) + effacement (0–3) + station (0–3) + consistency (0–2) + position (0–2), for a total of 0 to 13. There is no universally accepted cut-off (ACOG, 2025). The most common convention: 6 or less = unfavorable cervix, where cervical ripening is usually considered first, and 8 or more = favorable, ready cervix (NICE NG207).
The Bishop score table
| Factor | 0 | 1 | 2 | 3 |
|---|---|---|---|---|
| Dilation (cm) | Closed | 1–2 | 3–4 | ≥5 |
| Effacement (%) | 0–30 | 40–50 | 60–70 | ≥80 |
| Station (−3 to +3) | −3 | −2 | −1, 0 | +1, +2 |
| Consistency | Firm | Medium | Soft | — |
| Position | Posterior | Mid-position | Anterior | — |
| Total score | Interpretation on this page |
|---|---|
| 0–6 | Unfavorable cervix — cervical ripening is usually considered before oxytocin (NICE NG207: score 6 or less) |
| 7 | Intermediate (borderline) |
| 8–13 | Favorable — cervix ready for induction (NICE NG207: score 8 or more) |
ACOG (Clinical Practice Guideline No. 9, 2025) notes that there is no universally accepted definition of an unfavorable cervix, that thresholds from 3 to 8 have been used, and that parity and gestational age also affect the course of induction. Use the score together with your local induction protocol.
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What is the Bishop score?
A pre-induction assessment of the cervix described by Edward Bishop in 1964. Five findings from a vaginal exam — dilation, effacement, fetal station, consistency and position — are each given 0–3 or 0–2 points, for a total of 0 to 13. Higher scores mean a more favorable (riper) cervix.
What Bishop score is favorable for induction?
The most common convention is 8 or more for a favorable (ready) cervix and 6 or less for an unfavorable one. NICE guideline NG207 uses exactly these cut-offs: with a score of 6 or less it recommends pharmacological or mechanical ripening, and with more than 6 amniotomy and oxytocin. ACOG's 2025 guideline states that there is no universally accepted definition and that thresholds from 3 to 8 have been used.
What does an unfavorable cervix change?
With an unfavorable cervix, induction protocols typically start with cervical ripening (mechanical or pharmacologic methods) before oxytocin. The choice of method follows the local protocol and the clinical situation.
How is fetal station scored?
On the −3 to +3 scale relative to the ischial spines: −3 scores 0, −2 scores 1, −1 or 0 scores 2, and +1 or +2 scores 3.
What is the simplified Bishop score?
A three-component version using only dilation, effacement and station (0–9 points). In a 2011 study by Laughon and colleagues, a simplified score above 5 predicted vaginal delivery as well as a full Bishop score above 8.
What is the modified Bishop score?
Some modified versions replace effacement with cervical length measured in centimeters. This calculator uses the original five-component Bishop score.
Methodology & sources
- Total = dilation + effacement + station + consistency + position, using the point values in the table above (range 0–13).
- Interpretation bands follow the most common convention, as used in NICE NG207: ≤6 unfavorable, 7 intermediate, ≥8 favorable. ACOG (2025) does not set a single threshold.
- The score summarizes an exam; it does not replace clinical judgment or the unit's induction protocol.
Sources: Bishop EH. Pelvic scoring for elective induction. Obstetrics & Gynecology. 1964;24:266–268. Cervical Ripening in Pregnancy. ACOG Clinical Practice Guideline No. 9. Obstet Gynecol 2025;146:148–160. Inducing labour. NICE guideline NG207, November 2021. Laughon SK et al. Using a simplified Bishop score to predict vaginal delivery. Obstet Gynecol 2011;117:805–811. All arithmetic runs in your browser; nothing you enter is sent anywhere. This page is a reference tool for healthcare professionals. It does not provide medical advice or diagnosis.
Last reviewed: · Published by 55DIGITS LLC · Corrections: ep@tommano.com