Last evening, I had the chance to go to the Tampa Bay Birth Network meeting and hear midwives speak about their caregiving. A CNM, a birth center LM and a homebirth-only practicing LM were there speaking and the conversation turned on many interesting points. I also had the opportunity to speak to Alan Huber from the Controversies in Childbirth Conference and I'm excited to say that when it hits Tampa, I'm hoping it will provide many such opportunities for people on opposite sides of the table to find solutions and discuss the changes that need to be made for healthy births to re-emerge in hospital settings.

Before I get distracted, however, I want to come back to the idea of the midwives and their perspectives. This particular thought grabbed me and I can't seem to shake it loose today.

It was stated that a Bishop's Score for induction is actually a score that was determined by finding a percentage of women that would continue on to have a vaginal birth if only their water was broken. This is now extrapolated out to include pitocin and other drugs for induction but the score was not intended for that use originally. It also does not discuss the magnitude of a healthy outcome, simply a vaginal birth. This leaves a lot of leeway for birth trauma and other complications that can arise even with a vaginal birth. So the thought swimming through my head becomes: If natural birth advocates are always telling women to ask for a Bishop's score, do they know what it is they are using and is this really a foundational methodology for saying "no induction" or "induction is more likely to work"? I'd love some thoughts on this!