Why do we give babies points at delivery?

Hearing the Apgar score described as a “test” bothers me. But  Dr Virginia Apgar ’s evaluation system is, in fact, a score.  So it’s no wonder some people refer to Apgars as “baby’s first test.” 

We rarely hear the Glasgow Coma Scale or the Edinburgh Depression Scale spoken of as “tests” in the same sense – perhaps because they’re not applied to pretty much everyone who arrives in the world! But, like the Apgar, these scores were developed to identify people in need of help— by comparing them to a standard of wholeness, an ideal state of well-being. 

 Hearing people call the Apgar a “test” bothers me because—I’m judgy.  I want things to be Right. I was that kid with a reputation for correcting teachers.

Being judgy seems to be about the worst character trait anyone can have right now (ask our teenage and young-adult kids). Yet, for most of us, our default posture seems to be judging.  We judge ourselves and we judge each other. We criticize, finding–if not exactly fault, then room for improvement. We all fall short, and we know it. We’re all specialists in “the pointing of the finger and speaking wickedness” (Isaiah 58:9). We even find fault with God, because we see Him as judgy. 

Think about this, though: “critical care” is about caring, not criticizing.  

Dr. Apgar didn’t develop a scoring system so we could just look at babies in a “judgy” way.  The whole point of paying attention to the newborn’s transition is so we can help—to try to restore wellbeing and wholeness.  

When a baby needs resuscitation after delivery, we aren’t standing there thinking “hmm… how many points does this kid get?”  We’re hustling to help!  We have a timer going, we  keep track of what the baby needed from us at how many seconds/minutes of life, and then—once the resuscitation is over— we assign Apgars after the fact.  Someone “born almost dead” who needs extensive resuscitative measures will have lower scores; someone with a relatively smooth transition to extrauterine life will have higher scores.  

“Critical” can, of course, mean “judgy.“ The OED definition includes “(g)iven to judging; esp. given to adverse or unfavourable criticism; fault-finding, censorious.” But “critical” can also mean “analytical,” as in “(i)nvolving or exercising careful judgement or observation; nice, exact, accurate, precise, punctual.” Also, because the word relates to a crisis or a turning point, “critical” can mean “of decisive importance in relation to the issue”  as well as “involving suspense or grave fear as related to the issue; attended with uncertainty or risk” .  An even more obsolete medical definition in the OED is “relating to the crisis or turning-point of a disease” —i.e., the moment at which the progress of a disease turns away from death toward life.   

As Oswald Chambers wrote over a century ago, “What the word needs is not ‘a little bit of love’ but major surgery.”  We all have life-threateningly low scores—we are all, left to our own devices, in need of extensive resuscitation. 

The thing about being judgy is: it implies we have a standard.

We’re all starting a new year hoping for something better—or wishing that we could dare to hope.  We know our world doesn’t live up to our standards and, if we’re honest, we know we ourselves don’t either. 

The word “judge” is directly related to “justice”.  And the original Hebrew and Greek words for both justice and righteousness are directly related, overlapping.  You can’t have one without the other. 

Jesus was judgy.  He told the Pharisees—the ultimate judgy rule-followers—that they weren’t keeping the Law well enough.  They were focused on minutiae but they should have been paying attention to justice and righteousness in addition. He called out the young man who asked “what should I do?” by giving him another impossible task.

And then He went on to say that “with God all things are possible” — because He, the Judge, came to take all the judgment upon Himself—and to give us His own righteousness. Fulfilling the Law.  Making everything right.  Healing our diseases and dealing with our sin.  

He looked at that young man with love. And it’s not hard to imagine that He did love the Pharisees as well—if not, why bother correcting them? Why do parents correct their kids?… And why do we give babies points at delivery?

What if we were to accept God’s judgment as critically caring: as being ready to help us?  What if we were to realize that His anger is not at us, but at sin and brokenness?

In the end, our posture—critically judgy, or critically caring—has everything to do with the direction of our attention.  

Are we looking at each other—and at our own selves—with comparison, fear, and condemnation—what Isaiah calls “the pointing of the finger and speaking wickedness?”  Or are we looking at Jesus, the standard of wholeness and wellbeing: the One Who has taken on the curse of our condemnation and offered to clothe us in His own righteousness, to be our peace and to make us perfect in His love?

Let’s start the New Year fully judged—and fully resuscitated—in Him.