NEVER pull on the umbilical cord in an attempt to hasten the delivery of
c. When the placenta is delivered, place it in a basin or plastic bag. Take the
placenta to the hospital. The placenta will be examined to be sure that all the afterbirth
has been expelled.
d. Examine the perineum, which is the skin between the anus and vagina, for
lacerations. Apply pressure to any bleeding tears.
e. Place a sanitary pad over the vaginal opening.
f. Lower the mother's legs.
g. Prepare for transport.
2-15. ASSESSMENT OF THE BABY - APGAR
a. Your first concern is any life-threatening problem the newborn may have.
Therefore, begin your assessment by checking the newborn's airway, breathing, and
circulation. Included in your initial assessment is the newborn's ability to adapt to his
new environment upon birth. The APGAR score is used to measure this adaptability.
b. The APGAR scoring system was devised by an American anesthesiologist to
assess the physical condition of a newborn baby. This method assesses various
aspects of the newborn's health at one minute after birth and at five minutes after birth.
Evaluated are the infant's color (appearance), respiratory effort, muscle tone, reflex
irritability (grimace in response to slap), and heart rate (pulse). Each feature is given a
score of from 0 to 2. The numbers are added to give a total possible score of 10 (2
points in each of the five categories).
c. The APGAR score at the one-minute check and the five-minute check
indicate how the newborn is doing in the first few minutes of life. A low score on the
one-minute test will often improve on the five-minute test. This indicates that the
problem was temporary and has been corrected. Look at tables 2-1 and 2-2 to see the
scoring system and the meaning of the scores.