Bishop Score and Cervical Readiness

An induction plan begins with two separate questions: Does delivery need to be initiated, and is the cervix ready to respond? The Bishop score addresses the second question. It estimates cervical favourability—the degree to which the cervix has softened, shortened, opened, moved forward, and aligned with the presenting part—so the team can choose a sensible sequence of cervical ripening, amniotomy, and uterotonic therapy. A low score does not mean that induction is contraindicated or destined to fail. It means the cervix is still acting more like a firm barrier than a distensible passage, so ripening is usually needed before oxytocin. A higher score suggests that contractions are more likely to produce progressive dilation. The score is a planning tool, not a promise of vaginal birth and not a substitute for assessing fetal presentation, fetal status, the indication for delivery, or contraindications to labour.