Bishop Score

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Bishop Score

Some doctors are “induction happy.” They like to schedule their lives; it is a though job to be always on call. Often if they see you are getting impatient they’ll suggest and induction. Most doctors really believe that inducing is not harming the child; nevertheless inducing is indeed opening the door to possible complications, baby might not like pitocin and his heart rate may fall resulting in an emergency C-birth. You might not be able to take the strength of the contractions and you will ask for an epidural, which often opens the door for more medical interventions. One of the reasons for a high cesarean rate in this country is due to fail inductions. So ask questions and don’t seem impatient. At forty-two weeks gestation you might need to be induced.

BE INFORMED! Knowledge is power.

Find out what your Bishop score is. The Bishop’s score, is a pre-labor scoring system to assist in predicting whether induction of labor will be required It has also been used to assess the odds of spontaneous preterm delivery.For an induction to be successful, your Bishop’s Score should be greater than 9. Be sure to ask your caregiver for your Bishop Score.

Cervix Score
  0 1 2 3
Position Posterior Midposition Anterior
Consistency Firm Medium Soft
Effacement (%) 0-30 40-50 60-70 >80
Dilation (cm) Closed 1-2 3-4 >5
Station -3 -2 -1 +1, +2

Also many doctors induced on the bases of not enough amniotic fluids. In the last few weeks your amniotic fluids might be checked often, so will your baby’s heart beat. When you are getting the ultrasound the doctor or technician will calculate your levels Amniotic fluid index (AFI) .  If they say the levels are low, ask for numbers, an AFI between 8 and 5  or more with baby’s strong heart beat means all is well.  Less then five  you will be induced, The use of oligohydramnios  (low levels of amniotic fluids) as a predictor of gestational complications is controversial. 1 2.  Nevertheless, most doctors will strongly suggest induction.

Get a second opinion on your fluid levels at the hospital. Often a new inexperienced technician will miss-calculate, sometimes the machines at a dr. office are not as accurate as those at the hospital. If you are sent to the hospital for low fluids and IT IS NOT AN EMERGENCY (ask simply “Is this an emergency or do I have an hour before I go in.”  Usually once you get to the hospital it will take hours before you are actually induced, and if it is an emergency usually means cesarean.  SO ASK)

Before you go to the hospital get a good meal (once you get there they will not feed you till the baby comes.) This will only take thirty  minutes but it will make a huge difference in your energy level during the induction. If your water is intact and you feel like it, have sex with your partner as a way to ‘naturally induce”  Read the article about natural inductions.

Prepare yourself emotionally; being induced is not the end of the world. Many of my clients have successfully had a drug-free birth even when induced. Call your doula or your support team they will help. Take a moment and stay still (if you know how to meditate this is a great time to do so.) Center and tell yourself everything will be ok. Rushing to the hospital will get you off center. Low amniotic levels are not usually a terrible emergency. But remember there is always enough time to come back to center and talk to your baby.

Once you are at the hospital ask them to re-measure the levels. Ask for the numbers, if your levels are five or more centimeters tell them you want to leave. It is your right to leave, remember you are a client not a patient.

Leave and call your doctor tell him/her you’d like a little more time to see if the baby comes naturally. At this time I would advise acupuncture or a chiropractic visit to try natural induction. Hypnosis really helps to find out if there are any fears left that stand in the way of this birth, and to relax and accept the outcome. Get our Induction CD before this happens and get yourself ready to give birth when it is the right time for you and baby.

Often it is a real struggle to leave the hospital once you have entered following doctor’s orders. Choose your battle wisely, any day is a good day for a stress-free birth. If you decide to stay and begin the induction ask to manage the rate at which the pitocin is administer, and together with your birthing team you can embrace the contractions one at the time and one minute at the time. Binrg a friend or better yet a doula to your induction.  female friendship and company has been shown to reduce stress and prevent intervention such a cesarean. Usually nurses will come every fifteen to twenty minutes and automatically raise the pitocin levels without even asking you. Gently express your desire to manage the contractions and ask the nurse to tell you and ask you before she raises the level. You are not to follow a time schedule that was established by the hospital procedure, or the medical books, as long as your baby is doing well, and you are progressing there is no need to follow any schedule. Make friends with the nurse right away, ask her about her birth, her children, the weather, anything. Remember she is a human being and we all have a big heart even if it is hidden somewhere. Give love and you will receive love in return.
Gently manage your pictocin induced contraction one at the time, visualizing your cervix opening up. If you bishop score is low the doctor might suggest cervadil. Following is an article about the risks and the drugs used for induction. Again be prepared, ask a lot of questions to your care provider. The following information is not meant to scare you but to inform you. Whatever your birth will be will be ok for you will.