The rate of labor induction is increasing in the United States. Methods for quantifying cervical factors have been developed to identify patients who may benefit from cervical ripening before induction. The first cervical scoring systems used digital examination. More recently, cervical ultrasound and testing for the presence of fetal fibronectin have been suggested to evaluate cervical readiness for labor induction, but neither of these methods provides a significant improvement over digital examination. The Bishop score, the most widely used digital examination scoring system, still is the most cost effective and accurate method of evaluating the cervix before labor induction.