- Appearance (skin color) Aussehen
- Pulse (heart rate) Puls
- Grimace (reflex irritability) Reflexe
- Activity (muscle tone) Grundtonus
- Respiration - Atmung
Irish maternity hospitals have a long and strong tradition of active management of labour which ensures that the outcome 'mother and baby well' is among the highest in the World. If we take on board other outcomes like "demeaning, invasive interventions" "lack of continuity in the caring staff" "lack of options in delivery method" "high levels of Caesarian section" then the verdict is not so good. When The Boy was born in 1975 it was a very busy day for everyone involved. I spent about six hours on the buses of Dublin putting external things in place. Herself was getting denuded down there for no good reason and the obstetrician was poised with the knife helping things along with a bit of episiotomy to keep things on schedule. Nobody asked her about either of these things and she came out of the hospital delighted with her new status and, of course, The Boy but vowing never, ever to go back to a maternity hospital. That's what I mean: mother-and-baby-well = yes; severely pissed off customer = also yes. 18 years later, Dau.I was on the way and everyone assured us that things had improved immeasurably over the intervening two decades but a maternity ward delivery wasn't going to happen. We'd grown up as well and had travelled and knew that there were other options. We signed on with a domicilary mid-wife, one of the very few that was licensed to practice in the country who lived about 5km from the draughty, chilly, romantic 19thC farmhouse that we inhabited out near Dublin Airport.
Well, the whole experience was a blessing, a healing antidote to the humiliations of 1975. Kate-the-Midwife came a couple of times before-hand and was there for the delivery (of course) and fixed us all a cup of tea and then she went home for some sleep. But she came back in the afternoon to see if there was anything else she could do. And she came back every day for the next ten days. She was super-vehement that post-partum maternal bed-rest was important. As she explained, the uterus gets enormously bigger to accommodate the 3kg package with which it forms a mutually supportive structure. After delivery, the supports are limited to two small ligaments well designed for normal un-pregnant uterus, but a little under-engineered for the heavily vascularised model. The worst thing to do, said Kate, was vacuuming. The rhythmic motion could entrain the uterus [resonance] and might cause it to break loose from its moorings.
Mais revenons nous à nos
Q. Number of rubella cases last year in the US?
A. Ten. not 10 million.
If you are of the anti-vaxxer persuasion you might reflect on the numbers.
Apgar was also at the fore-front of getting rhesus blood tests done in all maternity hospitals, so that there would be no more cases of haemolytic disease of the foetus and newborn (HDFN) where the red blood cells of the newborn have been destroyed by rhesus incompatability with the mother. The Irish Blood Transfusion Board fucked up that intervention later on but we can hardly blame Dr Apgar for the complacent idiots who came after her. Later still she targetted premature babies with the slogan "Health Babies are Worth the Wait". She gave 25 years of her life to the March of Dimes becoming tireless in her advocacy for the health of mothers and babies.