
Understanding the APGAR: What Does Baby’s Score Mean?

The APGAR: The First Test Your Baby TakesΒ
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As a brand new mom, hearing a βscoreβ of your baby minutes after birth can be alarming. Many parents are not aware of what the APGAR is measuring and the purpose it serves for a newborn.Β The APGAR is a testΒ given after birth to evaluate how baby is doing immediately out of the womb. There are a number of misconceptions about the APGAR and in this article we will discuss what an Apgar score means, how to understand the Apgar scale, and when and how your baby will receive an Apgar test.Β

What is the APGAR Test?
The APGAR stands for:Β
A: Appearance (skin color)
P: PulseΒ
G: Grimace responses (aka reflexes)Β
A: ActivityΒ
R: RespirationΒ Β
The Apgar is given to newborns at 1 minute and 5 minutes after birth. The purpose of the Apgar is to provide the medical team with a view of the babyβs overall physical condition following birth. The Apgar scores of each newbornΒ helpsΒ the team to decide if medical care is needed after delivery. Midwives, nurses, OBGYNs and pediatricians use the Apgar to identify babies that may need extra support in oxygen, fluid clearing, blood circulation, or other supports. One example is helping a baby to clear amniotic fluid that may have collected in the lungs following birth. Another example isΒ identifyingΒ blueishΒ skin that can mean poor blood circulation in the early minutes of the babyβs life.Β
The History of APGAR Scoring
Virginia Apgar, a physician, and anesthesiologist, developed the Apgar test in 1952. Her goal was to quickly evaluateΒ babyβsΒ after they were born to mothers on anesthesia. It then became a newborn evaluation used on all babies. Many doctors have spoken about the importance of distinguishing that this is not meant to be an indicator of long-term health for babies, and what it evaluates is specific to the early minutes after birth.Β SomeΒ doctors question the reliabilityΒ of the Apgar because of sensitivity and specificity. It is important for new parents to know that this is one of many tools and the score does not determine long-term impacts on your child.Β Β
Understanding Your Baby’s APGAR Score
The Apgar score is out of 10 points. Each of the 5 sections of the Apgar is rated 0-2. Your baby will receive a score at 1 minute after birth and again at 5 minutes after birth. As an overall benchmark,Β a score of 7 or aboveΒ is a mark of good health in the immediate minutes after delivery. If the score is lower, it could indicate a problem that needs attention such as the airways or circulation. When a baby scores less than a 7, the team will continue to evaluation every 5 minutes for 20 minutes. In some cases, immediate intervention may be taken to assist theΒ baby in the transition.Β Testing at these two increments allows the medical team to evaluation the babyβs transition from the womb to the newborn stage.Β
APGAR Score Chart
AsΒ your baby is evaluated in 5 areas, you may want to understand the areas and the scoring. This chart is based on the information provided byΒ American College of Obstetricians and Gynecologists.
Appearance/Color:Β Β
0-Baby is blue or paleΒ
1- Baby isΒ acrocyanoticΒ
2- Baby is completely pinkΒ Β
Pulse/Heart Rate:Β
0-Pulse absentΒ
1- Pulse is less than 100 beats/minΒ
2- Pulse is greater than 100 beats/minΒ
Grimace Response/Reflexes
0-No ResponseΒ
1-GrimaceΒ
2-Cry or Active WithdrawΒ
Activity/Muscle Tone
0-LimpΒ
1-Some FlexionΒ
2-Active MotionΒ
Respiration
0-AbsentΒ
1-Weak Cry: HypoventilationΒ Β
2-Good,Β CryingΒ
