We are here to decode the APGAR score for you, shedding light on how this quick but thorough assessment paints a picture of your newborn's health. You'll gain insights into what exactly happens as your precious bundle takes their very first breaths, and why those initial moments are so critical.
You don't have to be a medical professional to understand the five key elements of an APGAR score—activity, pulse, grimace, appearance, and respiration. Today's session is packed with anecdotes and the kind of knowledge only years of hands-on experience can provide. So, whether you're a parent-to-be, a birth worker, or simply fascinated by the wonders of life's beginnings, tune in to the Ordinary Doula Podcast. Together, let's celebrate every birth story and arm ourselves with the wisdom to make those first minutes as joyful and informed as possible.
Visit our website, here: https://birthlearning.com/ Follow us on Facebook at Birth Learning Follow us on Instagram at @birthlearning
Show Credits
Host: Angie Rosier Music: Michael Hicks Photographer: Toni Walker Episode Artwork: Nick Greenwood Producer: Gillian Rosier Voiceover: Ryan Parker
We are here to decode the APGAR score for you, shedding light on how this quick but thorough assessment paints a picture of your newborn's health. You'll gain insights into what exactly happens as your precious bundle takes their very first breaths, and why those initial moments are so critical.
You don't have to be a medical professional to understand the five key elements of an APGAR score—activity, pulse, grimace, appearance, and respiration. Today's session is packed with anecdotes and the kind of knowledge only years of hands-on experience can provide. So, whether you're a parent-to-be, a birth worker, or simply fascinated by the wonders of life's beginnings, tune in to the Ordinary Doula Podcast. Together, let's celebrate every birth story and arm ourselves with the wisdom to make those first minutes as joyful and informed as possible.
Visit our website, here: https://birthlearning.com/ Follow us on Facebook at Birth Learning Follow us on Instagram at @birthlearning
Show Credits
Host: Angie Rosier Music: Michael Hicks Photographer: Toni Walker Episode Artwork: Nick Greenwood Producer: Gillian Rosier Voiceover: Ryan Parker
Speaker 1:
Welcome to the Ordinary Doula Podcast with Angie Rozier, hosted by Birth Learning, where we help prepare folks for labor and birth with expertise coming from 20 years of experience in a busy doula practice, helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.
Speaker 2:
Hello and welcome to the Ordinary Doula Podcast. My name is Angie Rozier. I'm your host and excited to be here with you today. We are hosted by Birth Learning. We are a birth doula, postpartum doula, lactation consult, doula training, postpartum dual lactation consults, doula training. We kind of have our hats and a lot of rings, but we love to help people prepare for childbirth with the things that we know and have learned and observed over the last 20 years. So hopefully you can take some of our experience and have it impact your birth experience. So, whatever you're here, for who, however you're here, welcome, we're glad to have you today.
Speaker 2:
So today I want to talk a little bit about APGAR scores. So maybe you've kind of heard about APGAR scores, but that is a simple assessment that is done on babies when they're born. It's done at birth. I'll tell you a little bit of history about the APGAR score. It was created by a doctor, a female doctor named Virginia APGAR in 1952. She was at Columbia University and she created a way to do a quick assessment on how babies were doing after birth and they came up with what we still use today. It's been modified a little bit over time but it's the APG score and it assesses five different aspects about the baby, about their physiology and their body within the first little, tiny, tiny bit of life. So those five things are activity for the A of Apgar, which is muscle tone. Are they moving, pulse, pulse, do they have a heart rate, grimace or reflexes or irritability, like? Is their face grimacing? Are they showing us some reflexes? Sometimes you'll get a really quick what we call moray reflex right after birth with the baby's arms. But what is what's their? Uh, the grimaces for, like their irritability and their body reflexes they're. The second a APGAR is for their appearance and this is often called their color. So babies are often born a bluish, purplish color and they quickly, as they get oxygenated and take breaths and their heart, a lot of the actual anatomy and physiology of a baby's internal systems will shift right at birth. It's pretty quick, but not it doesn't happen all in one second and they will start to oxygenate and they will turn pink. And then the R for apigar is respiration Are they breathing or making breathing efforts? So each one of these five things are given two points. So we've got five components, two points each. So we're on a scale from zero to 10, depending on what points the baby has for any one of these things, and this is done generally at certain times.
Speaker 2:
Whether you realize it or not, everything is being tracked very closely about your birth Nurses. If you're in a hospital or in a birth center, someone's doing this as well. At home births, as soon as this, the activity of birth starts to happen, people are very busy taking care of you, watching for things you may not even be aware of and doing some recording of things. So a lot of charting going on. So they track the time of birth and they know how old the baby is. So one of these assessments the first one, is done at one minute old. So sometimes you'll hear in the room one minute somebody will call out one minute, someone's aware the baby's one minute old. So sometimes you'll hear in the room one minute somebody will call out one minute, someone's aware the baby's one minute old and we give the baby some time to transition the baby, like I said, these changes happen. We need the baby to start breathing, but they have some time to make these changes. So at one minute old they assess and it's a visual assessment. You may sometimes see a nurse reach over and pick up a baby's arm and drop it to see what their muscle tone is like. But generally it's purely a visual assessment and if you don't know what was happening you wouldn't know what was happening. So that's happening at one minute old and usually a lot of times we'll bring in a baby nurse or a second nurse at delivery. That might be their role and responsibility to assess the baby. Sometimes they'll swoop in and give a little bit of help if needed.
Speaker 2:
The next APGAR score is given at five minutes. So they might say you might hear in the room five minutes and that's about all you'll hear. And there's another quiet, silent visual assessment. Usually that's done and the baby's given a score from one to zero. And doing our kind of our research, what I see most often is very common Apgar scores of eight and nine. So eight is the one minute and nine is the five minute. Very rarely do we get Apgar scores of 10, but eight and nine is healthy, super common. Anything below seven on an Apgar score and generally we anticipate APGAR scores go up. They're going to be going up as that baby takes those minutes that time to transition as their color. It's usually color they usually will get. If they're eight and nine. It's usually points off for color as they're getting that pink skin from becoming oxygenated by their own efforts. But usually they say one off or two off for color If needed.
Speaker 2:
If this baby's struggling, then there might be an APGAR score given at seven minutes and at 10 minutes. So if that's the case, this baby's being worked on, this baby's being assisted. This baby needs some additional, extra support. A lot of times that might be in oxygen. They might need some oxygen, help with oxygen or they have blow-by oxygen or have a mask. If they're bagged they might need some just physical stimulation.
Speaker 2:
If we can get babies crying a lot of times they'll clear their own airways. Sometimes they're struggling because there is fluid in their air rise. Sometimes they need full resuscitation depending on the severity of the transition that the baby's making. So if they have low APGAR scores they're going to need assistance and support and probably you won't be holding the baby in many cases if they're low. So C-section babies oftentimes will have lower APGAR scores.
Speaker 2:
So when babies are born by cesarean they don't go through the birth canal and the birth canal. Actually getting that good squeeze in the birth canal has a pretty awesome physiologic, anatomical purpose in that it squeezes down all the alveoli or the air sacs in the lungs VLI or the air sacs in the lungs, and when the baby emerges at birth, that pressure gradient change that is pretty rapid and immediate helps pop open those lungs. So babies that have not been through the birth canal and are born by cesarean might need a little bit of extra help in opening those sacs, all those individual VLI in the lungs. Sometimes a little bit of positive oxygen flow or air into those sacs will do that. So we anticipate babies with cesarean deliveries may have slightly lower APGAR scores and need a little bit of help to transition.
Speaker 2:
So in a cesarean we'll always have a little team there for the baby. It's usually three people. One of them is a respiratory therapist to focus on that exact thing. So Apgar scores you may hear them given in the room. You may want to ask about them. If your baby's Apgar scores are much lower than seven, especially at the one minute, you'll definitely know that your baby is needing some assistance. So I have seen Apgar scores of zero. That's terrifying and it's very alarming looking to everyone. So that baby isn't trying to breathe, it's not breathing, it doesn't have a heart rate.
Speaker 2:
There's no muscle tone, the color's rough, like the baby could be blue or gray and that's alarming looking. So we have teams of people who are very well trained. This is why they're there. Usually we don't need their expertise, but in the cases where we the baby needs challenge, you know, has a lot of challenges and needs a lot of support that's exactly where our team's in place and they know exactly what to do to help with that. Um, I have seen babies that need a lot of support. Um, as I look back on the moments of my career that were a little more on the terrifying side, this is a lot of times what they surround is the kind of support that baby might need at birth.
Speaker 2:
Some babies surprise us. They might not show any indications during labor delivery, based on the monitoring that we're doing, that they're going to need some help, and that's often the case. Sometimes there's not a surprise. We might see we might have the team incredibly ready, because the baby's given us signs and indications that they are struggling and they may need some extra support out of utero. Sometimes it's a high risk situation where we have a baby that we know is sick. We're going to be challenged in some way, and so the support is right there, ready to assist babies that need it in that way. So that's just a little bit about APGAR scores. Know what to listen for. You can ask before you know you leave your labor into the room, ask, hey, what are some babies APGAR scores? Likely they'll be 8 and 9, 8 and 8, 9 and 9, something like that could be pretty awesome. They're going to do this at home births. They're going to do this at birth center births. Wherever you are having your baby, they're going to assess the Apgar scores and know that they're most often off for color. All right, so a little bit more about Apgar scores.
Speaker 2:
As I have tracked our data over the years, I want to give you kind of. This is we're going on a sample of hundreds of our the records that we've kept. The average one minute Apgar score is 7.66. And the average five minute Apgar score is 8.85. So that is, if we round those up, that's average of eight and nine. Now we've seen some as low as zero and one that kind of pull those numbers down, but generally they're eight and nine. Now we've seen some as low as zero and one that kind of pull those numbers down, but generally they're eight and nine.
Speaker 2:
So I also did some research. I did a research internship with a community doula program and helped them track a lot of their data and aggregate their data. And what was cool about this program it's an incredible program that I absolutely love, but it's black doulas serving a black community and a community doula program. It's an incredible program that I absolutely love, but it's black doulas serving a black community and a community doula program. So their statistics on this their one minute APGAR score was 7.67, which is actually one hundredth of a point higher than the data set that we use, which was mostly white babies. And one cool thing about both data sets is they had doula support. So kind of interesting. That was a cool thing to realize. But their five-minute APGAR score was a little bit lower, so it was 8.73. So for the community doula program we worked with, their one-minute APGAR average was 7.67. Their five-minute was 8.73. So kind of interesting.
Speaker 2:
But if we round those up that's also eight and nine Apgar scores.
Speaker 2:
So consider what your baby's Apgar score is. After the fact. It's kind of an interesting thing to know, to know that they're what they're looking at, what they're assessing, as those babies are doing that amazing transition. If you can imagine what it must be like for them to come from an internal water world where you know all their processes are taken care of for them, and then they have to do a transition to breathing on their own, swallowing on their own, using room air, breathing with their lungs, their now becoming dry lungs. They're using their eyes differently, their ears, their sounds and sights and smells are so much more acute. That's got to be a little bit startling.
Speaker 2:
One really quick thing we'll say about that is that transition happens best on the mom's chest. So when we're doing skin to skin, that's where the baby can most easily make that transition from the inside to the outside. Not all babies have that luxury, if they need some extra help, if they're very premature, but we hope that that transition is done right on the mom's chest, where Apgar scores can also be done. So thanks for being here to learn a little bit more about Apgar scores. Again, my name is Angie Rozier and this is the Ordinary Doula Podcast. I hope you do something that brings you so much joy today. Go out and find that joy and hopefully it's connected to somebody else. Do something that will lift someone else today. We will see you again next time. Thanks for being here.
Speaker 1:
Thank you. Thank you for listening to the Ordinary Doula podcast with Angie Rozier, hosted by Birth Learning. Episode credits will be in the show notes Tune in next time as we continue to explore the many aspects of giving birth.