My friends at “Preparing For Birth” posted the following…

“Induction is serious business — the holiday season is upon us — be wary of convenience labor induction to avoid a holiday birth day — knowing your bishop score can help you make this decision.”

This really got me thinking as I have several holiday babies scheduled in the next few weeks.

I started really looking at the Bishop Score to see how all of my mommies are faring at this point. And then I began to consider how care providers look at this and make their determinations.

If in the next few weeks, as these women have their next round of appointments, and their care providers start talking induction, what is my appropriate behavior as a certified DONA doula? I know it is not appropriate for me to contradict the medical professional or give any kind of advice at all. After all…I am not medically trained.

But it is within the scope of my profession to supply information so that informed decisions may be made by these future mommies.

And so…..I choose to post the Bishop Score.

Parameter/Score      0                       1                             2                       3

Position                Posterior      Intermediate       Anterior


Consistency         Firm              Intermediate       Soft


Effacement           0-30%           31-50%                   51-80%           >80%


Dilation                 0 cm                 1-2 cm                   3-4 cm             >5 cm


Fetal Station         -3                      -2                            -1,0                   +1, +2

Here’s how it works… Next time you have a vaginal examine  (at 40 weeks plus unless you really want to consider induction before full term)  you might ask your provider the following: uterine position, cervical consistency, cervical effacement, dilation, and the station of your baby.                                            You can find definitions of these terms in a good reference book such as Pregnancy, Childbirth and the Newborn by Simkin et al., or TheThinking Woman’s Guide to a Better Birth by Henci Goer.

“A score of 5 or less suggests that labour is unlikely to start without induction.  A score of 9 or more indicates that labour will most likely commence spontaneously.                                                                                                                                          A low Bishop’s score often indicates that induction is unlikely to be successful. Some sources indicate that only a score of 8 or greater is reliably predictive of a successful induction.”                                                                                                                   From Wikipedia

Wait a minute……I ask you to consider these two paragraphs  again. Hmmm…

Modified Bishop score

“According to the Modified Bishop’s pre-induction cervical scoring system, effacement has been replaced by cervical length in cm, with scores as follows- 0>3 cm, 1>2 cm, 2>1 cm, 3>0 cm.”

“Another modification for the Bishop’s score is the modifiers. Points are added or subtracted according to special circumstances as follows:

One point is added for:

1. Existence of pre-eclampsia

2. Every previous vaginal delivery

One point is subtracted for:

1. Postdate pregnancy

2. Nulliparity (no previous vaginal deliveries)

3. PPROM; preterm premature (prelabor) rupture of membranes

From Wikipedia

Just some things to consider.

As I always say……your body, your baby, your birth!

And Happy Holidays!!!

“Pitocin is the most abused drug in the world today.” ~Roberto Caldreyo-Barcia, MD

I feel so very sad when I see pitocin being given to a woman for induction or augmentation of labor. I will not argue that there might be legitimate times it is needed…but I still feel sad.

I always wonder if I, as a doula, have given this woman enough information about this harsh, harsh drug. Even though they say it is chemically the same as our natural drug, oxytocin, it does not treat our body, or our baby, the same. In addition, it disrupts the natural processes in so many ways.

I suppose I feel so very sad because it reminds me that I was given pitocin 33 years ago. I did not even know what was going on, much less that I had the right to ask…or dare say no.

Thank God that my child does not seem to have any side effects that are being associated with pitocin, such as ADHD or Autism. Nor does he have brain damage due to loss of oxygen when the cord became entangled as he twisted desperately against the harsh contractions. He does still have the grey patch of hair where the internal monitor was screwed into his scalp.

I, however, was not unscathed. Even though my baby was in the best of positions prior to the pitocin, as he tried to escape the drug induced  contractions, he kept landing against my lower spine. As a result, I have Degenerative Disc Disease, Arthritis, and Spinal Stenosis, all of which are progressive.

In addition, these harsh contractions kept my baby’s head pushing, pushing so very hard against my cervix, which was just not ready to open because it was just not time. The result of this violation was abnormal, pre-cancerous, cervical cells. After many procedures to prevent the path to cancer, I ultimately had a hysterectomy. It was then found that my equally violated uterus had not one, but two, tumors that had not been present prior to my labor and delivery.

No more babies for me, but at least I would be here to watch my one child grow up, get married, and hopefully have the large family he, and I, have always wanted so much.

I am not a medical doctor. I do not pretend to be one. I just feel so sad when I see a woman being given pitocin.

Kenny Shulman CD(DONA)