Tests After Delivery

Before your baby leaves the hospital to go home with you, he or she will have to undergo some tests to assess overall health and to help doctors know whether they need to offer any special care. It’s possible your baby may require additional testing if needed.

Apgar score

This is a test done as soon after birth as possible to help decide whether your baby needs special care. The letters in “Apgar” stand for the five things the test measures:

  • Activity (muscle tone)
  • Pulse (heart rate)
  • Grimace (reflexes)
  • Appearance (how does the skin color look)
  • Respiration (breathing)

Each checked item will receive a numeric score from 0 to 2, and the individual scores will be added together to get a total Apgar score. The tests are usually performed within the first one to five minutes of birth. If the original score is low and additional care is needed right away, they will retest at the ten minute mark to see if any of the care provided has helped with your baby’s condition. A score between 7 and 10 usually means your baby won’t need help beyond the routine post-delivery care. A score between 4 and 6 may mean your baby will need some help breathing, but sometimes that help involves simple measures like suction, massage or oxygen. A score of 3 or less may indicate that your baby needs immediate care to help resuscitate him or her. If your baby is born prematurely or is delivered by c-section, he or she may have a lower-than-expected Apgar score. Try not to worry. There are many things that can be done to help your baby recover and thrive.

Newborn screenings 

All hospitals are required to test every baby born at their hospital for some rare metabolic diseases. These are simple blood tests that can help doctors detect serious illness early, which can minimize or even eliminate permanent damage. Blood is often drawn from your baby’s heel with just a small needle prick. The disorders tested for may include:

  • an enzyme deficiency called phenylketonuria (PKU)
  • thyroid deficiency
  • cystic fibrosis
  • sickle cell disease
  • MCADD
  • inherited disorders that leave the body unable to process amino acids (protein building blocks), including maple syrup urine disease, glutaric aciduria type 1 and isovaleric acidaemia
  • homocystinuria

There are a number of other screenings the pediatrician may request based on the health of your baby. For more information on those screenings, visit the Michigan Department of Community Health website.

Hearing screening

The American Academy of Pediatrics (AAP) recommends that hospitals screen the hearing of all babies born at their facility before they leave the hospital to go home for the first time. A hearing screening is important because it’s not always possible to identify hearing loss just through observation. If your baby has hearing difficulties, he or she could lose valuable time developing speech. If your child has hearing loss, the hearing screening will help detect it so it can be treated early, and the necessary interventions can begin.

Overall physical exam

Before your baby leaves the hospital to go home with you, a health care provider will perform a head-to-toe physical exam. The exam looks at the head, eyes, ears, mouth, heart, lungs, genitals, skin, hands and feet, spine, hips and reflexes. The exam helps health care providers identify any potential conditions or problems that might require further testing or treatment.

If you have additional questions about tests your baby may undergo after he or she is born, ask your health care provider for more information.

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