Ateneo de Zamboanga University

College of Nursing
NURSING SKILL OUTPUT

Bishop Scoring in Induction of Labor

DEFINITION

It is a system used by medical professionals to determine the likelihood that you will go
into labor in the near future. He or she will use this information to determine whether or not to
recommend induction and how likely it is that an induction will lead to a vaginal delivery.

The score takes into account a variety of factors related to your cervix and the position of your
baby. You are given a grade for each factor, and then your total score is calculated by adding all
of the factors together. Due to the fact that it was developed by Dr. Edward Bishop in the 1960s,
it is known as the Bishop score. Here are some examples of specific Bishop Score ranges and
what they mean: If they have 8 or more points, they may be able to go into labor naturally, or if
they need to be induced, they will most likely be able to deliver the baby vaginally. Obtaining 6
or 7 points places in the middle of the scale and doesn't give a clear indication as to whether or
not inducing will be effective. If the score is 5 or lower, it indicates that inducing labor is less
likely to result in a vaginal delivery, and that a cesarean section (C-section) may be necessary if
the mother cannot wait to induce labor. If they have a score in this range, it indicates that they
may require medication, known as cervical ripening agents, to help prepare the cervix for
delivery if induction is recommended.

MATERIALS/EQUIPMENT

 Synthetic prostaglandin
 Small hook instrument
 Synthetic version of oxytocin (Pitocin)
 PRELIMINARIES

It will consider a variety of factors, including the mother's health, the health of the baby, the
mother's gestational age, weight, and size, the baby's position in the uterus, and the status of the
cervix, in order to determine whether labor induction is necessary. Labor induction is performed
in a hospital or birthing center, where both the mother and the baby can be closely monitored and
where labor and delivery services are readily available to the mother. However, some steps may
be taken prior to admission to ensure that the patient's safety.

STEP-BY-STEP PROCEDURE

BEFORE PROCEDURE

 Prepare the necessary equipment needed.

Rationale: In order to provide the best possible patient outcome, it is critical that all equipment
be built, calibrated, and tested prior to being used.

 Introduce yourself and verify the client’s identity. Explain what you are going to do, why
it is necessary. Explain the procedure to the client properly.

Rationale: Allows establishing a good first impression by making the family feel at ease, and
increase family cooperation and reassurance.

 Perform hand hygiene and observe other appropriate infection control procedures

Rationale: Prevent the transmission of bacteria and infection.

 Provide client’s privacy

Rationale: Keeping a client's dignity and comfort in mind necessitates protecting their privacy.

 The patient may need to remove their clothing and put on a gown.

Rationale: In order to provide modesty for the patient and some dignity under the circumstances.

 Monitor baby’s heart rate

Rationale: in order to raise the alarm if the baby is not getting enough oxygen.
DURING PROCEDURE

 Insert the finger into the vagina and through the cervix if they find that it’s already
slightly open.

Rationale: This will separate the membranes from the cervix.

 Manually separate the amniotic sac from the lower part of the uterus.

Rationale: It will cause the release of prostaglandins. The release of prostaglandins may ripen
the cervix and possibly get the contractions going.

 Have a synthetic prostaglandin inserted into the vagina in the form of a pessary or gel.

Rationale: These act like hormones and can help the cervix dilate and efface, which might bring
on labor.

 Monitor baby’s heart rate

Rationale: in order to raise the alarm if the baby is not getting enough oxygen.

 Rupture the membranes.

Rationale: Sometimes this alone can be enough to start the contractions, meaning it wouldn’t
need to progress to the next stage of induction.

 Intravenously give a synthetic version of oxytocin (Pitocin)

Rationale: a hormone that stimulates the contraction of the uterus If labor has already begun,
then oxytocin is more effective at speeding up the process (augmenting it) than it is as a cervical
ripening agent.

AFTER PROCEDURE

 Monitor baby’s heart rate

Rationale: In order to raise the alarm if the baby is not getting enough oxygen.
  Rest quietly. Depending on how they feel the next day, they may be able to return to their
normal activities.

Rationale: It enables the body to repair and be fit and ready for another day.

Submitted by: Juwak, Jassim A. Signature:

Date: 03/20/2022 Class Instructor: Darwina I. Halbi

References:

Labor induction - Mayo Clinic. (2020, May 13). Https://Www.Mayoclinic.Org/Tests-

Procedures/Labor-Induction/about/Pac-20385141. https://www.mayoclinic.org/tests-
procedures/labor-induction/about/pac-20385141

What Is the Bishop Score? (2021, June 1). Verywell Health.

https://www.verywellhealth.com/bishop-score-5183938

Young, B. (2017, November 2). Understanding Your Bishop Score and What to Expect from Labor
Induction. Healthline. https://www.healthline.com/health/pregnancy/bishop-score#process