Routine Newborn Care: How Contractions and Apgar Score Impact Your Baby’s First Moments

After delivery, most newborns ≥35 weeks gestation adapt well to life outside the womb, requiring only routine care. Managing contractions for a healthy birth, monitoring newborn care like assessing Apgar scores, and addressing newborn needs are critical aspects of this process.

Delivery Room Care: Contractions and Newborn Care

Immediate Management

Routine delivery care focuses on ensuring the newborn's immediate safety and comfort. This includes drying the baby, gently clearing the airway of secretions to promote breathing, and providing warmth to stabilize body temperature. Understanding how contractions influence the baby’s transition during delivery allows medical staff to better anticipate any need for resuscitation or additional support. The Apgar score is then used to quickly assess the newborn’s overall health to determine readiness for routine care and identify any immediate concerns.

Assessment and Care of Newborns

Immediately after birth, a quick evaluation of the newborn's clinical condition is performed, focusing on gestational age (GA), muscle tone, and respiratory effort [1].

Newborns who meet the following criteria are typically eligible for care in a standard nursery (neonatal level 1) [2]:

• Gestational age of 35 weeks or more.
• Good muscle tone.
• Strong respiratory effort, indicated by crying and breathing without difficulty.

Babies who meet these standards usually do not require immediate medical intervention. They can remain with their mother for skin-to-skin contact (kangaroo care), which fosters bonding and supports early breastfeeding initiation [3].

Newborns born before 35 weeks of gestation or those with complications generally require specialized care in higher-level neonatal facilities (level 2, 3, or 4), based on their gestational age and overall health status.

Importance of the Apgar Score: A Standardized Newborn Assessment

The Apgar score is a universally recognized method used to evaluate a newborn's condition immediately after birth. It is calculated based on five key factors, with each assigned a score of 0, 1, or 2. This scoring, performed at one and five minutes after birth, determines if additional interventions are necessary. An Apgar score calculator can assist in determining the overall score. 

The Apgar score evaluates the following:

• Heart rate
• Respiratory effort
• Muscle tone
• Reflex irritability
• Color

The Role of Apgar Score and Contractions in Transition

Assessing Apgar Scores

The Apgar score helps guide clinical decisions during the critical first minutes of life. A score of 7–10 typically indicates a healthy baby, while lower scores may necessitate additional care.

Transition After Contractions

After the intense contractions of labor, the baby undergoes a physiological shift to outside the womb. Monitoring the Apgar system ensures proper adjustment and identifies any immediate concerns.

Newborn Nursery Care

Routine assessments, including vital signs, feeding patterns, and jaundice checks, rely on early evaluations like the Apgar score. After labor's contractions, maintaining warmth and monitoring the baby’s transition are crucial steps in the nursery.

Follow-Up Care 

Follow-up care ensures continued health after labor and delivery. By evaluating how the birth process, including contractions, impacted the baby and reviewing the Apgar score results, healthcare providers can address any remaining concerns, providing reassurance and support for the baby’s well-being at home.

The follow-up visit should involve evaluating the newborn's overall health and behavior, observing the interaction between the baby and mother, assessing the parents' well-being, confirming continued healthcare plans, and providing education and guidance for the parents.

References:

1. Aziz K, Lee HC, Escobedo MB, et al. 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics 2020. 

2. American Academy of Pediatrics Committee on Fetus And Newborn. Levels of neonatal care. Pediatrics 2012; 130:587. 

3. Feldman-Winter L, Goldsmith JP, COMMITTEE ON FETUS AND NEWBORN, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME. Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns. Pediatrics 2016; 138. Reaffirmed 2022.