What the heck is an APGAR score?

Virginia_Apgar

The APGAR score was created by Virginia Apgar in 1952 to quickly assess a newborn’s well being. APGAR stands for: Appearance, Pulse, Grimace, Activity, and Respiration. It is performed by taking noninvasive observations done at least twice: once at 1 minute after birth, then again at 5 minutes after birth. However some caregivers also take a third set of measurements at 10 minutes after birth. The lowest score a baby can receive is a 1, with 10 being the highest.

Sign

0 Points 1 Point 2 Points

Appearance

Pale blue-gray Pink body with blue extremities Whole body is pink
Pulse (Heart rate)* No heartbeat Below 100 bpm

Over 100 bpm

Grimace (Irritability)

No reaction Grimacing Grimace with another response (i.e. cough)
Activity Loose/Limp Low tone—arms and legs close to body

Active

Respiration Not breathing Slow/irregular

Crying

**bpm = beats per minute

What does the score mean?

Typically a score of 7 to 10 indicates the baby is in healthy standing. (Although 10 is very rare since most baby have blueish extremities.) A score lower than 7 indicates the baby may need a little extra time to acclimate to life outside the womb, and medical attention may be needed. It is normal at the first minute for the score to be lower than at the 5, or 10 minute mark.

Some common reasons a baby may have a lower APGAR:

  • Your baby was a C-section.
  • Your labor was particularly difficult.
  • Your baby may need help clearing their airway or some extra stimulation to “get them going.”

One good thing about the APGAR scoring is that it is noninvasive—you can still participate in skin to skin when they take your baby’s vitals.

Knowing what exactly the APGAR means can help you understand what to expect immediately following delivery, which can help ease anxieties. Always talk to your midwife, OB, Doula, etc. if you have any questions or concerns.

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