Tuesday, May 12, 2009
Jack's Apgar
Yesterday when we went to the pediatrician I finally learned what Jack's Apgar score was when he was born. This is a number to interest of most new parents, although it doesn't signify all that much, only the conditions on the ground of the baby's first five minutes of life. Here's the Wikipedia definition:

The Apgar score was devised in 1952 by Dr. Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after childbirth. Apgar was an anesthesiologist who developed the score in order to ascertain the effects of obstetric anesthesia on babies.

The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria (Appearance, Pulse, Grimace, Activity, Respiration) are used as a mnemonic learning aid.

Here is a breakdown of the Apgar scale:

0 - Baby's entire body is bluish-gray or pale
1 - Baby's body has good color, with a bluish tinge to the feet or hands
2 - Good color over entire body

0 - No heart beat
1 - Fewer than 100 beats per minute
2 - More than 100 beats per minute

0 - No response when airways are suctioned
1 - Baby grimaces during suctioning
2 - Baby grimaces and pulls away, coughs, or sneezes during suctioning

0 - Baby is limp, no detectable movement
1 - Baby displays some flexing of arms and legs
2 - Baby moves vigorously

0 - Baby is not breathing
1 - Baby cries weakly, may sound like whimpering, with slow or irregular breathing
2 - Baby cries strongly, with a normal rate and effort of breathing

So you understand that in each category the baby is given a score and then the total is determined at one minute and five minutes. So, if I recollect correctly, Emma's Apgars were 8/9. So she was looking pretty good at one minute and at five minutes she added a point in one category or another.

Jack's Apgar score was 2/9. The pediatrician was a bit shocked when he saw it because (in 22 years) he'd never seen a one-minute score that low jump to a nine like that. The spread was impressive to him. I was a bit shocked myself. I was shocked to learn that at a full minute of life my baby had been so lifeless. Look at the categories above and figure that Jack scored zeros in at least three categories and ones in two. Or zeros in four and two in one. That's a pretty damned bleak picture.

Never in my life has time slowed down more than the few seconds it took in the operating room when Emma was born for her to start breathing and let out those first outraged cries. Time. Slowed. Way. Down.

Imagine waiting on Jack, who apparently didn't cry for more than a full minute. Who had to be carried to a resuscitator and bagged before he came to life. It was a blessing that I was under and that M wasn't in there. Ditto when the forceps came out. I'm sure M would have about croaked to see that too.

The irony is that it was the general anesthesia that caused the problem. The general goes to the mama and then to the baby. That's why it became a race for the surgical team to get Jack out as fast as possible.

So with the Apgar Giant Leap we have another great story (now that it's safely behind us!) of Jack's smashing debut into this world :)