What is the Apgar score?
The Apgar score is a simple evaluation that tells doctors your baby's overall condition based on the observations in the first moments of life. This test is done to check if your baby needs help breathing or if he has heart problems.
Apgar is an acronym that stands for the following criteria:
- Aappearance
- Ppulse (heart rate)
- Gthese, grimaces (reflexes)
- Aactivity (muscle tone)
- Rexpiration (respiratory effort)
A pediatrician, OB/GYN, midwife, or nurse will assign your newborn an Apgar score of 0 to 2 on each of five criteria, for a total of 10 possible points. The higher the Apgar score, the better the baby is doing.
What is considered a normal Apgar score?
The Apgar test measures your baby's heart rate, breathing, muscle tone, reflex response, and color in the first few minutes of life.
- An Apgar score of 7 to 10 means that a newborn is in good or excellent health and usually requires only routine postpartum care.
- Apgar score of 4 to 6 it means that the baby is in good condition and may require some resuscitation measures.
- If the Apgar score is less than 4 it means that a newborn is in poor condition and needs immediate medical attention.
How does the Apgar score work?
This is how the Apgar score works:
Appearance/Skin Color
Is your baby's skin pink (healthy) or blue (unhealthy)?
- pale blue: 0
- Pink body, blue limbs: 1
- Pink all over: 2
pulse/heart rate
Using a stethoscope, the doctor or nurse will listen to your baby's heart.
- Heartbeat is not detectable: 0
- Heartbeat of less than 100 beats per minute: 1
- Heartbeat of 100 beats per minute or more: 2
Grimace/Reflexes
Reflex fussiness, also called a wince response, is the way your baby reacts to stimulation, such as a light pinch (don't worry, it doesn't hurt).
- No response to stimulation: 0
- Making faces: 1
- Grimacing with cough, sneeze or lustful crying: 2
Activity/Muscle Tone
This category measures how much the baby moves.
- Loose, flaccid or inactive muscles: 0
- Some movement of arms and legs: 1
- Lots of activity: 2
Breathing/Respiratory Effort
Here the doctor, midwife or nurse will check how well your baby is breathing.
- No breath: 0
- Slow or irregular breathing: 1
- Good breathing (crying): 2
Does a low Apgar score mean your baby will not be healthy?
While Apgar test can tell a lot about your baby's condition in the few minutes after birth, doesn't tell you much about anything in the long run. In fact, even babies whose scores are still low at 5 minutes are usually completely healthy.
All babies get at least two Apgar scores in the delivery room. The first test will be done 1 minute after birth to see how well your newborn got through labor and delivery.
At 5 minutes after birth, the test will be repeated to see how he is now that he is in the world. Most low scores at 1 minute are normal 5 minutes later. Occasionally, a baby with a low score at 5 minutes can be tested again at 10 minutes.
If your baby has a low Apgar score, he may need oxygen or airway clearance, or he may need physical stimulation to increase his heart rate. Most of the time, a low Apgar score is the result of a difficult delivery, cesarean section, or fluid in the baby's airway.
What else do you need to know?
The Apgar score was created in 1952 by anesthesiologist Virginia Apgar, MD, to check if babies needed resuscitation after their mothers received anesthesia during childbirth. In the past, it was used to predict if a baby would survive or she would have neurological problems, and doctors used it to diagnose birth asphyxia.
Since then, research has shown that a baby's Apgar score is not a good indicator of choking and does not predict neurological problems in full-term or premature babies. Today, your baby's Apgar score isn't considered a sign of anything other than how he's doing in the first few minutes of life.