If the birth goes smoothly and the baby is full-term, after delivery the midwife dries the baby with a warm cloth diaper, places them naked on the mother’s bare abdomen, and covers them with another warmed cloth diaper so that the head remains uncovered. Before the umbilical cord is cut, ID wristbands are put on both mum and baby. The baby then rests on mum for at least 1 hour.

We call this the sacred hour (the golden hour after birth). During this time, the midwife assesses the baby using the Apgar score at 1 minute, 5 minutes, and, if needed, 10 minutes. If there are complications during birth (C-section, vacuum extraction, if the baby is premature, twins, and so on), a paediatrician is also called in and examines the baby immediately after birth. . In this case, the Apgar score is given by the paediatrician. Otherwise, a paediatric examination immediately after birth is not necessary, and the baby is examined within 24 hours after birth.

The newborn’s initial care depends on their vitality, which we assess using the Virginia Apgar score (APGAR score). Apgar introduced the system in 1952. The score allows us to quickly check the newborn’s heart, lung, and neurological activity at specific time intervals after birth, and thus describe the newborn’s overall condition. This way, all healthcare professionals in the delivery room will know what each score means, even if they are not right next to the newborn.

The score at 1 minute usually determines immediate procedures for the newborn, while the scores at 5 and 10 minutes can already give some indication of the child’s later psychomotor development. The newborn receives points (0–2) for each of five characteristics, arranged according to the initials in APGAR; the total score is the sum of the points (Table 1).

Table 1: Mnemonic and scoring method according to V. Apgar

A good Apgar score at 1 and 5 minutes is 8–10. Newborns with a score of 5–7 are moderately asphyxiated; suctioning the upper airways and short-term oxygen ventilation via a mask is usually sufficient. A low Apgar score (0–4) indicates severe asphyxia and requires immediate action so that we may still be able to avoid the consequences of asphyxia. Resuscitation procedures follow the ABCD rule.

Don’t worry if your newborn doesn’t get a score of 10, as only a few healthy newborns achieve it. This is because most babies have acrocyanosis immediately after birth. This is the expected bluish colouring of the palms and soles due to changes in blood circulation that happen right after birth.

The Apgar score is a subjective assessment. This is why it is only one of many assessments used to evaluate a newborn’s overall condition.

Labour itself has a significant impact on the Apgar score, so prepare for it with the online lecture LABOUR or with A slightly different childbirth class. In A slightly different childbirth class, you’ll also learn more about your newborn, and you can also get to know them better in the online lecture About the newborn.

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