As soon as you give birth, you'll notice the medical professionals in the room picking up your newborn and checking if he's breathing. They will instantly follow this up by sharing a few--what may seem like random--numbers with each other. But these numbers aren't just any off-the-cuff figures. They help doctors and nurses determine how your baby is doing, commonly called the Apgar score.
These scores assigned a minute after labour is beneficial for assessing your baby's heart rate and umbilical artery blood gases.
But how do the medical professionals assess and assign these Apgar scores, and what does it mean if your baby is given a score of 1? Let's find out.
What Is APGAR Score
The Apgar score is assigned to newborns after birth 1 minute and 5 minutes.
- The 1-minute score is to determine how well your baby handled the birthing process,
- While the 5-minute score is to check how your baby tolerates being out of the womb.
The test may be given again if your baby is found to have a few concerns regarding their condition.
Interestingly, the word 'Apgar' comes from Dr Virginia Apgar who created the system in 1952. Since then, medical professionals have used this benchmark to determine a newborn's health. It is now an acronym that stands for and checks the following:
- Appearance or the skin colour of your baby.
- Pulse of your newborn's heart rate after birth.
- Grimace response or reflex is judged by placing a catheter or syringe on your baby's nose to check for their response.
- Activity or their muscle tone.
- Respiration is your baby's breathing rate and effort.
All of these are examined, and your baby's Apgar scores are assigned after the birthing process.
The American Academy of Pediatrics clarifies that this test can not necessarily predict how your little one will grow up and develop. But it can alert the medical professionals if the baby is slow to respond to stimulation and if they need further assistance in adapting to the new surroundings.
How to Calculate Apgar Score
Apgar scores are based on five factors. Your newborn will be examined on these factors to check the overall health and each would be scored on a scale of 0 to 2.
A score of 2 is the best a newborn can get for each factor. Then all the figures are added up for a final score between 0 to 10. Your doctor, midwife or nurse will typically add up your baby's Apgar scores.
While 10 is the highest possible score, only a few babies are given this score. That's because most newborns still come out with their hands and feet blue until they are warmed up enough.
APGAR Score Chart
Take a look at how these scores look, what they mean and how your baby will be scored in the table below.
Apgar Scoring System
| Apgar Score | 0 | 1 | 2 |
| Appearance | Bluish-grey or pale skin | Pink skin with bluish hands and feet | Normal pink skin |
| Pulse | Absent or no pulse found | Heart rate is below 100 beats per minute | Normal heart rate with above 100 beats per minute |
| Grimace response | Absent or no response whatsoever | Grimaces only with stimulation | Grimaces, coughs, sneezes, pulls away or cries |
| Activity | No movement and is limp | Can flex arms and legs a bit | Active movements |
| Respiration | Absent or no breathing | Breathing is slow and irregular; cries weakly | Normal breathing rate and effort; can cry strongly |
APGAR Score Meaning
- 7 or above: Newborn babies are considered to be in good health if they score a 7 or above, which is usually the case in most births.
- Between 5 and 7 at one minute: Your baby might have gone through some problems during the birthing process and it may have lowered the oxygen in their blood to get this score. But don't worry, the hospital staff will do their best to improve their oxygen supply so their 5-minute score can end up somewhere between 8 and 10.
- Less than 5: Only a small percentage of babies get this score. Babies born prematurely or delivered through emergency C-section have a higher chance of getting low scores. This may be due to the complications your baby had during labour. According to the American Academy of Paediatrics, it may also indicate problems with the heart or respiratory system.
However, these low scores aren't that bad. Getting a low score does not mean your newborn is unhealthy. It only means that they need immediate medical care that may include helping them breathe better by providing oxygen.
If your baby's score does cause a sign of concern, your doctor or midwife will let you know. They may even suggest the care and treatment your baby will need.
Yes, being a new parent may be overwhelming, and the process of labour and scoring doesn't make things easier. But just remember that this crucial measure is needed to get your baby the additional help they need. Once your little bub is settled well by the medical professionals, it is only a matter of time before you'll have a healthy and happy baby back home.
What Is the Normal APGAR Score for Newborns
The APGAR score is a method for assessing the health of newborns, and it's based on a few things:
One minute after birth: Appearance
Skin colour is pink (or bluish) and appears stretched tightly over the body. The baby cries vigorously, breathes normally and moves its arms and legs actively.
Five minutes after birth: Pulse, grimace, activity and respiration
The baby's heart rate should be at least 100 beats per minute. The baby should grimace or move when stimulated by rubbing the sole of its foot with a blanket edge. It should also cry loudly. The baby's breathing rate should be at least 60 breaths per minute.
Low APGAR Score
A low APGAR score is a sign that your newborn needs medical attention.
The Apgar score rates your baby on a scale from 0 to 10 in five areas: heart rate, respiratory effort, grimace response, muscle tone, and skin colour. If your baby scores less than 7 in any of these areas at 1 minute after birth and 5 minutes after birth, you may be at risk for problems with your newborn's brain development and long-term health.
Suppose your doctor is concerned about your newborn's APGAR score. In that case, they will probably recommend that you seek further evaluation by a specialist or have an echocardiogram or other test performed on your baby.
Causes of Low APGAR Score
Many factors can lead to a low APGAR score. A low score can be caused by the baby being premature or born with serious health issues, such as heart failure. Other reasons for a low APGAR score include:
- The mother's health during pregnancy
- Complications during delivery
- Infections in the mother or baby
- Maternal drug use (including alcohol)
Knowing the APGAR score can help doctors determine whether a child has had a normal delivery and the degree to which they may require additional medical attention. If your doctor does not provide an APGAR score, you can always request that it be included in your baby's medical record at the hospital.
Updated by Pheona Ilagan
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