When using anesthesia regularly with births in our parent’s generation, one doctor became particularly concerned about the effects of anesthesia drugs on newborn babies. Virginia Apgar wanted to know in a quick and efficient, yet accurate, manner if the immediate physical state of a baby was worrisome or not. Knowing quickly could change the outcome of a child’s life in extreme circumstances.
So she developed what is now known as the Apgar score, measuring various aspects of a newborn’s state in order to know if any immediate medical help is needed for the baby.
What Does Apgar Score Mean?
Even though this funny word can be remembered by the following acronym, it’s really just named after her, obviously, as you read before. But these can help you remember what the measurements are:
A – Activity (muscle movement)
P – Pulse (heart rate)
G – Grimace (reflexes and reactions)
A – Appearance (skin color)
R – Respiration (breathing)
So your doctor or midwife is going to rate each of these observations from your baby atleast twice: 1 minute and 5 minutes after birth. If assistance has been necessary, sometimes a third measurement will be taken at 10 minutes depending on the case.
Each aspect gets a score of 0, 1 or 2 and then added all together for a total score out of 10. Here’s a table with the different details per individual score.
|Activity||baby is limp with no movement||baby is flexing arms and legs a little||baby is actively moving naturally|
|Pulse||baby has no heart rate present||baby’s heart rate is less than 100 beats per minute||baby’s heart rate is at least 100 beats per minute|
|Grimace||baby isn’t responding to stimulation like airway suction||baby grimaces during suctioning||baby grimaces and tries to pull away from suctioning, coughs or sneezes|
|Appearance||baby’s entire body is pale or bluish-gray||baby has good color with bluish hands and feet||baby has great color all over|
|Respiration||baby isn’t breathing||baby may cry weakly, breathe slow and irregular||baby cries good and strong, normal rate of breathing|
What’s a Good Score?
When your baby scores a 7 or higher, then there is no worry for immediate attention; they are doing great and are expected to flourish just fine in the few days after birth.
A score or 4-6 means your baby may need additional help for breathing or something else may be wrong. Your doctor will be able to determine the issue quickly and intervene appropriately in order to help your baby recover from their birth and function normally.
Lower scores under 4 mean there’s a high chance your baby will have extreme complications they may not be able to recover from.
Your baby will most likely have a lower score in a few cases:
- if you’ve had a c-section
- if you’ve had an epidural
- if your delivery was very difficult or complicated
- if your baby is premature
Typically, the second score will be a little bit higher than the first score taken, simply because baby has adjusted to their new environment and their lungs are working more effectively now.
But know this….even if your baby’s score is slightly lower than desired, it does NOT mean that your baby is necessarily unhealthy or will have complications. It usually just means that your baby needs some oxygen for a short time or more physical stimulation.
It’s also very rare to have a perfect score of 10 because most babies have a little bluish color to their limbs upon delivery, which quickly disappears as they begin breathing on their own and start warming up.
I would always ask the nurse after my boys had been out for a few minutes what their score was, mostly because I was bored as doc was stitching me up and I couldn’t do anything else. I don’t remember exactly, but I think both of them had scores of 8 and 9, made me feel good.
What the Score is NOT
The Apgar score is not and never was intended as a long-term measure for health of your baby. Although, very low scores under 4 after the first 20 minutes of life have been known to correlate to disease and increased chances of infant mortality.
The Apgar score is also not something that you doctor will even mention. I simply learned about through reading and found it interesting. Neither of my doctors or nurses said anything until I simply asked about it. Here I am with our third baby birth, asking my nurse about his score.
So feel free to ask if you’re curious. It can help you understand more about how your baby is doing after they have arrived. Yes, they’ll put him or her right in your arms immediately upon delivery. But then they’ll take baby aside for weight and other measurements or necessities. When you’re just laying there, it can be something you chat with your team about.
But if anything, it’s educational, and you may even impress them by asking. Best to your baby’s Apgar score!