What’s an Apgar Score?

While many people are familiar with the term Apgar score and want their child to have a “good” score, most parents don't know the different things doctors and nurses look for when calculating an Apgar score. 

The first minutes of baby’s life often include a flurry of activity; parents are meeting their babe for the first time, babies are meeting their parents for the first time and doctors, nurses or midwives are often standing by to make sure that mother and baby are doing well.

As mother and baby cuddle up for that first skin-to-skin snuggle they’ll notice their doctor or midwife hovering over baby, doing some initial assessments of their health. These first quick assessments are then noted and an Apgar score is calculated. Apgar scores range from 0-10 and are used to determine whether a baby needs additional care or if they are safe and healthy snuggled up with their mama. So, what’s in an Apgar score?

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Apgar stands for appearance, pulse, grimace response, activity, and respiration. Each area is scored between 0 and 2 and the scores are totaled to calculate a baby’s newborn Apgar score.

When looking at a baby’s appearance, doctors are mostly noting skin tone. Babies who score a 2 are normal and pinkish all over. Babies who score a 1 are mostly pink but may have blue hands or feet. Babies who score a zero may be bluish all over.

Birth is exhausting for newborns, so it’s no wonder their little hearts are pumping with might during their first few minutes of life. When scoring pulse, a heart rate of 100 or above scores a 2, a heartbeat below 100 beats per minute scores a 1, and a non-existent heart rate score a 0.

After checking a baby’s appearance and pulse, doctors will take note of a baby’s grimace or reflex irritability. A newborn who scores a 2 will sneeze, cough, or pull away with stimulation. A baby who scores a 1 will move their face but no other muscles, while a baby who scores a 0 won't respond at all to stimulation.

Activity is assessed by observation — usually healthy newborns are at least a little wiggly. A baby who scores a 2 on activity will wiggle and move spontaneously. A baby who scores a 1 will flex their arms and legs but move little else. A baby who scores a 0 will have no movement at all.

Respiration is assessed by observing how the baby is breathing. A newborn who breathes and cries regularly will score a 2, while a baby who is struggling to breathe will score a 1, and one who’s not breathing at all will score a 0.

While most parents feel comfortable with a high Apgar score, a low score does not necessarily mean that a baby is unhealthy, only that it may need some immediate medical care. A score of 7 or higher means that a baby does not need any additional immediate care while a lower score might lead to some additional monitoring or care.  

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So, as you hold your sweet, wiggly newborn to your chest don’t be surprised when your baby’s doctor makes some observations and then assigns your baby an Apgar score — now you know just what that means!

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What’s an Apgar Score?

Julia Pelly has a master's degree in public health and works full time in the field of positive youth development. Julia loves hiking after work, swimming during the summer and taking long, cuddly afternoon naps with her two sons on the weekends. Julia lives in North Carolina, with her husband and two young boys. You can find more of her work at JuliaPelly.com ... More

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