Is My Body Ready For an Induction?
You may have heard or read that inductions can prolong labor and make the already long and arduous process of labor and childbirth take even longer. Nobody wants that, right? But perhaps you’re facing a medical issue, like Preeclampsia or Gestational Diabetes, which is making an induction an unavoidable step in ensuring the health and safety of you and your baby. Or maybe you’re 10+ days past your estimated due date and receiving pressure from your care providers to induce labor.
Is there any way to know if your body is ready for an induction? Yes, there is!
The average gestation of a human baby can vary anywhere between 37 to 42 weeks, and inductions may occur at any time in this window contingent on the particular circumstances of the pregnancy. Depending on where you land on the gestational continuum, you will be at greater or lesser degrees of readiness of going into labor on your own, which in turn will affect the success of an induction. The way to calculate this readiness is called the Bishop’s Score. It is a metrics that assesses 5 physical conditions of the cervix and baby’s position within the pelvis, assigning a number to each condition in order to determine overall readiness for labor.
In order to make an assessment, your care provider will need to perform a vaginal exam and will assign a number between 0 and 3 to each of the following five conditions to determine your overall Bishop Score:
- Cervical dilation in centimeters, i.e., how far the cervix has opened (e.g., closed to 5+ cm)
- Cervical effacement, i.e., how thin your cervix is based on percentage (e.g., 0%-80%+)
- Cervical consistency (e.g., firm, medium, soft)
- Cervical position (e.g., pointing posterior, mid-position or anterior)
- Fetal station, i.e., the position of the fetal head in relation to the pelvic bones (e.g., -3 – +2 cm)
A higher Bishop score, e.g., a score of 8 or higher, indicates a high likelihood of going into labor spontaneously or a successful induction. A score of 6-7 indicates a lower likelihood of spontaneous labor and induction may or may not be successful. A score of 5 or lower would indicate an even lower likelihood of spontaneous labor and induction will likely not be successful. Approximately 20% of inductions are not successful, i.e., active labor isn’t achieved; in these cases another induction may be attempted at a later date or labor subsequently starts on its own.
Before agreeing to an induction, whatever the reason, you may want to first request that your care provider perform a vaginal exam and determine your Bishop Score before making any further decisions about the timing. If for example you’re ten days past your guess date and you score an 8 or higher, you may decide to decline an induction since spontaneous labor is imminent. On the other hand, you may agree to induction since your cervix is “favorable” increasing the likelihood of it being successful.
If you fall into a high-risk category which is making induction a necessity for a healthy outcome, it’s still good to find out your Bishop Score so you can better anticipate the length of time your induction may take and the types of procedures that will be used to increase the likelihood of a successful induction.