APGAR Score for Newborns

Your Baby's First Test

Baby Eye Ointment at Birth
An APGAR score is given to newborn babies at one and five minutes.. Photo © iStockPhoto

Newborns have a tough transition from being in the uterus to the outside world. The vast majority do just fine, but the APGAR score has come about as a way to give a numerical representation to how well the newborn baby is adjusting. This is done by the midwife, nurse or doctor at one minute and five minutes after the birth. Your baby may also be given an APGAR score at 10 minutes if the first scores were low.

APGAR scores are given in all birth settings: hospital, birth center, home.

The APGAR score ranges from 0-10, with 10 being the highest score a baby can get. The baby is given points in five categories:

  • skin color
  • heart rate
  • respiratory effort
  • muscle tone
  • reflex irritability

In each of the categories, a baby can earn 0, 1, or 2 points. The points from each of the categories are added together for the total score. While these scores are done, they are not as useful as you might believe.

For example, if your baby is born and is visibly struggling, no one will wait until the one minute mark and subsequent APGAR score to assist your baby. They will begin working with your baby to help them adjust to life outside the womb. APGAR scores are also not translatable to later test scores, like the SAT or ACT.

With the advent of the skin to skin policies in many hospitals and birth centers, I'm often asked in childbirth class about how the APGAR test will be done.

While your baby is skin to skin, you will have a nurse or doctor assigned to watch your baby. This is done while standing next to you. The goal is to only separate or disturb your skin to skin time if you or your baby needs medical help.

"The APGAR really worried me, I really wanted to be skin to skin and not have my baby removed.

I also really wanted to hold them and have them safe," said one second time mom. "Thankfully, I didn't even notice anyone but the baby and my family. Later, I remembered about the APGAR and I apologized to the nurse that we forgot. She laughed and told me what the scores were. Apparently, I was the only one who missed it!"

The APGAR score was developed by Dr. Virginia Apgar, an anesthesiologist, in 1952. She used her last name as the acronym:

  • A = Activity
  • P = Pulse
  • G = Grimace
  • A = Appearance
  • R = Respiration

Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Fifth Edition.

KidsHealth.org. What Is An Apgar Score? Accessed 1/25/11 http://kidshealth.org/parent/pregnancy_center/q_a/apgar.html

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