All About Apgar Scores

You've heard about Apgar Scores and you know it's a way for doctors to see how well your baby is doing after the birth, but you're not really sure how it works. The gist of the Apgar scoring is that your baby will be tested one minute after the birth and again five minutes later. The Apgar scores tell your doctor whether your baby is healthy and fit or whether he may need medical attention.

The test was developed by Virginia Apgar, an anesthesiologist, in 1952. Today, the test is used all over the world. The Apgar test assigns numerical ratings to your baby's appearance, pulse, breathing, muscle activity, and responsiveness. The numbers run from 0-2. The numbers are then totaled. Ten is considered to be a perfect Apgar score.

There's a mnemonic device for remembering what it is the doctors test for when giving a newborn his Apgar score. Think Apgar: Appearance, Pulse, Grimace, Activity, and Respiration.

Skin Color

*Appearance represents the baby's skin color. A score of zero means the baby's complexion is blue-gray or pale. Good color but with bluish extremities rates a one. Nice pink all-over color gets a two.

*Pulse is the baby's heart rate. No heart rate gets a zero. Less than 100 beats a minute rates a one. 100 or more beats per minute rates a two.

*Grimace is the normal newborn reflex during the suctioning of his airways. If there is no response to having his airways suctioned, the baby gets a score of zero. A grimace during the suctioning rates a one. If the baby grimaces and coughs, sneezes, or pulls away during suctioning, he gets a two.

Active Baby

*Activity relates to the baby's muscle tone. A limp baby who doesn't move rates a zero. A baby who exhibits some flexing of the arms and legs gets a one. An active baby gets a two.

*Respiration is breathing. If the baby isn't breathing he gets a score of zero. If his cry is weak, like a whimper, or his breathing is slow or irregular, he receives a score of one. A nice strong cry and steady easy breathing gets a two.

If your baby gets a score of 7-10 during the one minute Apgar test, he's in good shape and needs no extra medical attention other than what is standard after delivery. Often, the baby has blue hands and feet at the one minute test, and then he'll pink up; so don't get too worried if he doesn't have an immediate perfect score of ten. If the baby scores from 4-6, he might need some help with his breathing. Maybe he needs to be suctioned again or be massaged a bit. Or perhaps he needs some oxygen.

Needs Help

A baby with a score of 3 or less needs some intensive help. He may need resuscitation. It's still not time to be alarmed. He may be just fine with a bit of help.

At the five minute mark, a score of 7-10 is normal. A score of 6 or below at this point may indicate your baby needs medical assistance. Your doctor will need to determine what needs to be done to help your baby.