By Howard J. Bennett, MD
It’s well known that fathers become anxious during labor and delivery.1 This is especially true for first time dads who have been observed shouting expletives at anyone wearing booties and a facemask. In the past, no one quantified this stress or proposed effective ways to help nervous fathers-to-be. After years of painstaking research, I have come up with a scoring system like the one Virginia Apgar developed 45 years ago.2 My test is performed like the traditional APGAR score, only in this case the examiner pays attention to the father instead of the baby.
APGAR Scores for Dads (ASD) are assigned right before delivery and at 1 minute after birth. Like the original APGAR score, the father is evaluated in the delivery room based on five easily determined signs (Table). The first ASD is a guide to the father’s well being and tells the doctor how likely it is that (a) he will be punched out, or (b) he will have to resuscitate a 180-pound adult on a cold linoleum floor. The second ASD tests the dad’s resiliency and lets the doctor know how well he is adjusting to his new role as a parent.
I am currently investigating the long-term implications of a high 1-minute ASD. It’s too soon to tell, however, whether a high score predicts that a dad will help change diapers or eagerly wake up at 3 a.m. to feed a hungry baby.
How to Interpret the ASD
A score of 10 indicates that the dad is in the best possible condition and will, in all likelihood, not only pay his bill but donate large sums of money to his doctor’s favorite charity.
A score of 7 to 9 signifies that the dad is in pretty good shape and a lawsuit is highly unlikely. The parents will probably say nice things about their doctor at family gatherings and cocktail parties, even if they complain about his not coming to the labor room often enough to check the epidural or refill the water pitcher.
A score of 4 to 6 indicates that the dad needs medical attention. In many cases, this score results from a strangle hold placed around the father’s neck by his wife. A strong nurse should be able to extricate the dad in between contractions and his score will improve accordingly. In other situations, physical stimulation and a little oxygen should do the trick. One classic approach is a quick slap on the cheek accompanied by the statement, “Snap out of it man, you’re about to become a father!” Dads with an ASD less than 7 should not be allowed to cut the cord because they will probably take off one of the doctor’s fingers instead.
APGAR Scores for Dads
A score of 1 to 3 means things are pretty dicey. Valium, smelling salts, and intravenous Coke have all been used successfully in this situation.3 In many cases, however, all that’s required is to prop the dad in an easy chair and let him watch videotapes of sitcoms from the 1950’s. Back then, all men had to do was sit in the waiting room until their little bundle arrived, all clean and snug, in the nurse’s loving arms.
When used as suggested, APGAR Scores for Dads will help doctors manage the most neglected member of the family unit. Fathers will appreciate the attention and, if they survive the delivery, they might even reproduce again.
1. Randolph D: Controversies in cord clamping: catch the baby or catch the dad? Archives of the Uterus 1996;43:127.
2. Apgar V: A proposal for a new method of evaluation of the newborn infant. Current Research in Anesthesthesia & Analgesia 1953;32:260.
3. Ferguson L: How to manage dads who faint in the delivery room. Journal of Dubious Investigations 1997;39:658.
© 2012 Howard J. Bennett. All Rights Reserved.
(First published in The British Medical Journal December 1998.)
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please visit Dr. B’s website at http://www.howardjbennett.com