Oxygen, the most essential and urgent ongoing need

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The Apgar score devised over 50 years ago reflected the perceived need to remove the newborn from the "sterile field" for repair of the episiotomy, manage delivery of the placenta, and to give the infant to neonatal specialists, often for resuscitation.

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The Apgar score is all about how well a newborn establishes respiration, and the ominous outcome if failure to breathe persists.

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Oxygen is the most essential, and urgent, ongoing need of all organisms dependent upon aerobic metabolism.

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Oxygen delivery throughout gestation is provided by the placenta, and the umbilical cord is the unborn child's life-line to the placenta.  Erasmus Darwin wrote in 1801:

"The placenta is an organ for the purpose of giving due oxygenation to the blood of the fetus; which is more necessary, or at least more frequently necessary, than even the supply of food."

Erasmus Darwin (1801) Zoonomia; or, The Laws of Organic Life, Section XXXVIII online at:

http://www.blackmask.com/thatway/books180c/zoon.pdf

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http://www.blackmask.com/thatway/books180c/zoondex.htm

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Erasmus Darwin 1731-1802

Problems with the placenta or umbilical cord before birth are of great concern.

Placental respiration continues after birth, unless the umbilical cord is cut.

Nevertheless, by the time Virginia Apgar developed her scoring system for evaluation of the newborn, clamping the cord within the first minute or two after birth was coming into vogue.

Posted: February 27, 2006 (a work in progress)

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