The Apgar score is a scoring system that only applies to newborn babies. The reason it’s referred to as Apgar is that it was created by Dr. Virginia Apgar in 1952, who used her name as a mnemonic for each of the five categories that are scored. Today the system is used by doctors and nurses to assess the infant health soon after birth, typically twice, once at one minute after, and again at five minutes after birth. An RN or physician may announce these scores to the labor room to let all present healthcare personnel know how the baby is doing.
When parents hear these scores, the immediate thought is often, “What exactly does that mean?” While the Apgar score is a quick and easy way to let everyone in the room know what the baby’s condition is as soon as she or he is born, there are other assessments used as well, like heart rate monitoring.
Categories Scored
Each score is on a scale of 0 to 2, with 2 the best score possible, it includes:
- Appearance (meaning skin color)
- Pulse (heart rate)
- Grimace (the reflex response)
- Activity (muscle tone)
- Respiration (effort and breathing rate)
The five scores are then added up, with 10 the highest score possible. Keep in mind that few babies get a 10 as most have blue hands and feet until warming up, detracting from the appearance score.
Good Apgar Scores
Of course, every parent wants their baby to be scored as high as possible. What is a good apgar score, you might ask? A baby who scores 7 or above is considered to be in good health, although a lower score doesn’t necessarily mean that your baby isn’t healthy. It often means there is some immediate medical care needed, such as oxygen or suctioning of the airways to help him or her breathe better. Many healthy babies get lower scores, particularly in their first few minutes of life.
One study, published in the journal PLOS One, found that babies given a score of 7 or higher had neonatal and post-neonatal mortality rates that decreased progressively with gestational age. Those with very low scores at five minutes had increased mortality rates.
Low Apgar Scores
If your baby scores low, remember that many do just fine, growing into healthy babies shortly after adjusting to life outside the womb. A low score at the first minute, even as low as 2 is quite common, but often after five minutes, the score will be in the healthy range. For example, if the mother has received some pain medication shortly before delivery, sedation may affect the score, causing the baby to be a bit sleepy and unable to put in a lot of respiratory effort.
If the score is still under 7 at the five-minute mark, don’t panic. Often there’s simply a need to look at the bigger picture for more clues as to how a baby is transitioning to newborn life and what occurred to have made the transition bumpier than expected. More information may need to be taken into account when interpreting the score.