What is the Apgar score?
An Apgar score is a simple way for doctors or midwives to quickly assess the health of a newborn.
The test is performed one minute after your baby’s birth to see how well your baby coped with the birth process and again at five minutes – to see how well your baby is adjusting to their new environment.
At a glance
- The Apgar score is a simple way for doctors or midwives to asses the health of your newborn
- The score ranges from 0-10, broken up into 5 groups of 0-2
- The test will take place twice after birth, immediately after and five minutes later
The results range form zero to ten and are determined by evaluating five criteria.
The Apgar scale gets its name from the medic who founded it, though it has since become an acronym for each of the criteria under scrutiny:
- Appearance (skin colour)
- Pulse (heart rate)
- Grimace (reflex response)
- Activity (muscle tone)
- Respiration (breathing)
The test takes place so soon after the birth that you may not even be aware of it being performed. The midwife checks over the baby’s skin colour, heart rate, reflex response, muscle tone and breathing.
Each of the five criteria is given a score between zero and two, to give a total of up to 10.
Although most babies will have no issues, these early tests are a vital part of postnatal care. If your midwife has any cause for concern she will arrange for immediate treatment.
Your midwife will also check your baby’s height and weight, mouth, temperature and number of fingers and toes.
What is your midwife looking for?
Skin colour: Blue all over scores 0, Pink body, white extremities scores 1, Pink all over scores 2.
Heart rate: No heart beat scores 0, Slow heart rate (less than 100 beats per minute) scores 1, Adequate heart rate (more than 100 beats per minute) scores 2.
Reflex response: No response scores 0, Grimacing in response to stimuli scores 1, Grimacing plus crying or coughing scores 2.
Muscle tone: Limp or floppy scores 0, some movement and flexing scores 1, Active motion of the limbs scores 2
Breathing: Not breathing scores 0, Slow or irregular breathing scores 1, Breathing well, and crying scores 2
Deciphering Apgar scores
The vast majority of newborns tend to score between seven and 10 and do not require additional treatment. However, certain conditions such as a difficult or premature birth can give an artificially low score that doesn’t accurately reflect the health of your baby. The use of pain relief can also affect scores.
A score of 8-10
In most cases, if your baby scores between 8 and ten, he’s in excellent condition and will not require anything more than routine care.
A score of 5-7
A baby scoring between 5 and 7 is usually in fair condition but may need a little bit of help with breathing. Your midwife may rub his chest or extremities to assist.
A score under 5
Babies with a lower score may require additional heat, light and oxygen via medical equipment. Pediatric support will be also be given and the test will be routinely repeated until the infant is in a stable condition.
Points to remember
The Apgar scoring system was not created to predict or warn of long-term health or developmental issues. A low score at five minutes does not necessarily indicate poor health. Also, if your baby has a low first score but then a normal second score, this is counted as normal.
Keep in mind that the Apgar score is just one of many ways to measure a newborn's vitality. There are further tests and examinations that take place in the subsequent weeks and months after birth that will be used to assessing your infants health.