The Apgar Test
Your baby is given the Apgar test immediately after delivery. This test is used to assess whether your baby needs extra medical care right away. Each of five signs is rated on a scale of zero to two, with ten the best possible total score. Babies with breathing problems or nervous system problems may need extra care.
The Apgar score is determined twice -- one minute after birth and again five minutes after birth -- and gives your caregiver an idea of whether these problems exist. Usually, scores of between seven and ten are signs your baby is in good condition. If his scores are below seven, your baby may be taken to the nursery for observation and care. Be sure to ask about your baby's Apgar scores.
Within the first hour after birth, most babies receive a medication in their eyes. This might be erythromycin or tetracycline (both antibiotics) or silver nitrate. As required by law in all states and provinces, these medications are given to prevent infections of the eye, which could result in blindness.
On rare occasions, a mother may have organisms in her vagina which, if picked up by the baby during birth, could cause eye infections. Gonococcus and Chlamydia are two common organisms that can cause serious problems. Because we do not have laboratory tests that are 100 percent accurate in discovering whether a woman has these organisms, laws exist to protect babies who might be infected unknowingly.
Many parents prefer the antibiotic ointments over silver nitrate since they do not burn or irritate babies' eyes as silver nitrate does. Your baby's vision is blurred until the ointment is absorbed.
This immediate care can be done with your baby in your arms or very close by. Once these procedures are completed, you may spend some uninterrupted time with your baby. Although your nurse or midwife observes the baby and periodically checks your temperature, your blood pressure, and the condition of your uterus, she should try to stay in the background and disturb you as little as possible.
This is the time when you and your partner can become acquainted with the baby and start the first feeding if you plan to breast-feed. Most parents describe this as a wonderful time. Usually the baby is alert and calm, very interested in your faces and voices and in the new sounds he hears. When held close to your breast, your baby begins nuzzling and licking, and then takes the nipple in his mouth and begins to suckle.
Even after a long, tiring labor, you and your baby will probably be wide awake and interested in each other. After spending one or several hours together, both you and the baby will doze off, possibly very soundly.
The Apgar test is a preliminary check, designed to minimize the intrusion into your getting-to-know-you session. In the next section, find out what takes place in the more detailed examination later in the day.
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