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Postpartum - After Delivery

APGAR Testing

Apgar testing is the first and quick assessment of the overall health and well-being of a newborn baby. The Apgar testing system was first implemented in the 1950's by an obstetric anesthesiologist, Virginia Apgar. Apgar testing is now commonly used to assess newborn babies in their first few minutes after birth.

Apgar testing is the child's first test, but it is not necessarily meant to be a predictor of future behavior and development. Apgar testing is done immediately after delivery. Usually the doctor will record the Apgar scores in the first minute after birth and again five minutes after birth. The Apgar test is a great way for doctors to be able to do a quick evaluation to make sure the baby is developed, healthy and thriving. Depending on the scores of the Apgar, the doctor can usually tell if there is something wrong with the baby and if immediate assistance is required to keep the baby alive and well. 

Apgar Testing:

The first one-minute Apgar assessment is used to reveal information about the baby's overall physical health. This is when doctors will check the baby to make sure he or she is breathing correctly and has a proper heart beat. If there is something wrong with the heart or with the baby's breathing, the doctors are able to take immediate steps to get resuscitate the baby if necessary. If the baby is fine, the second Apgar test will be done a few minutes later, usually at the 5-minute mark. This second portion of the Apgar testing assesses how the baby has responded to any resuscitation attempts.

The Apgar tests a few important variables during these tests including the baby's color, heart rate, reflex, muscle tone and respiratory efforts. If all of these show well, the baby will likely score high on the Apgar testing chart. The scores are given between zero and two of each condition, with the total result of up to 10. If the one-minute Apgar tests scores between seven and 10, the baby will likely only need routine post delivery care. If the scores are less at around four to six, this means that the baby may need some assistance in breathing or using its respiratory system. If the scores are less than four at this point, that usually means life-saving efforts must be used to keep the baby breathing and alive. 

In the five-minute Apgar test, the score of seven to 10 indicates normal and healthy for the new baby, If the score drops below seven, the doctors and health care professionals will most likely monitor the baby closely and retest using the Apgar testing tools every five minutes up to 20 minutes. Just because the scores might be lower than seven at this point, that does not necessarily mean there will be any long-term problems with the baby. It simply means they just need to be closely monitored for the short while after birth to ensure he or she is okay and continues to stay healthy and thriving. 

Apgar Testing Results:

  • Heart rate - 0 = no heart rate, 1 = fewer than 100 beats per minute (the baby is not very responsive), 2 = more than 100 beats per minute (the baby is vigorous).
  • Respiration - 0 = not breathing, 1 = weak cry, sounds like whimpering or grunting, 2 = Good (strong) cry from baby.
  • Muscle Tone - 0 = limp, 1 = some flexing and bending of arms and legs, 2 = active motion.
  • Reflex response - 0 = no response to airways being stimulated by doctor, 1 = grimace or notice of discomfort during stimulation, 2 = grimace and coughing/sneezing during stimulation.
  • Color - 0 = baby's entire body is blue or pale in color, 1 = good color in the baby's extremities, 2 = completely pink and shows good color. 

Before you go into labor and deliver your baby, it is a good idea to know how the Apgar testing works and what you can expect to see from your baby. it often helps new mothers feel more reassured about the health of their baby after deliver while the baby is having their Apgar testing done. 


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