Birth Plans

Am I ready to be induced?

If you decide it is best for your baby to be born right away, your chances of a successful induction will be dependent on your body's readiness for labor. A woman with a "ripe" cervix is more likely to be successful at an induction. The measurement of readiness is called the Bishop's Score, and it is determined by assessing the state of your cervix.

During a vaginal exam, your midwife will check your cervix for effacement, dilation, position, and consistency. She will also check your baby's station, meaning how high or low in your pelvis he is sitting. There is some evidence that using dilation alone is a better predictor of induction success, so if you score well enough to be induced but have little to no dilation you may want to wait a few days.

Bishop Scoring

Score 0 1 2 3
Position Posterior Intermediate Anterior N/A
Consistency Firm Intermediate Soft N/A
Effacement 0 - 30% 40-50% 60-70%r 80-100%
Dilation Less than 1 1 - 2 cm 2 - 4 cm More than 4 cm
Fetal Station -3 -2 -1 or 0 +1 or +2

What if my body is not ready?

If the induction cannot be postponed and your Bishop's Score is low, you may undergo a two part induction. Your induction would begin with prostaglandin E2 to ripen the cervix. This is generally started in the evening and you will need to spend the night in the hospital. In the morning you would begin artificial oxytocin.

For most women induction is a slow process. Plan for the induction to take 24 hours or longer if your cervix is not ripe. Induction is working against your body, not with it. It is possible for an induction to go faster, but don't expect it.

References:

Goer, Henci. The Thinking Woman's Guide to a Better Birth. 1999. New York: The Berkley Publishing Group.
Enkin, Keirse, Nilson, Crowther, Duley, Hodnett and Hofmeyr. A guide to effective care in pregnancy and childbirth Third Edition. 2000. Oxford: Oxford University Press.