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.
| Measure | 0 | 1 | 2 |
| 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.
But you don’t need to worry about that because you are eating healthy and treating your body good and doing what you can to ensure a successful labor and delivery.
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.
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But if anything, it’s educational, and you may even impress them by asking. Best to your baby’s Apgar score!
Hello I’m not sure what my sons apgar score means. He has the symptons of quad cerebral palsy and has seizures now. His score was 1 min 8 5 min 9. Anyone has a clue as to what this means
Hi Carmella. That has to be hard for you. Scores of 8 and 9 are actually pretty great! It means that his vital signs are fantastic. APGAR score does not look at symptoms for other conditions like down syndrome or cerebral palsy. I would encourage you to work with your baby’s pediatrician in order to determine next steps in the health care of your son. I wish you the best.
I’va always wondered how rare perfect 10’s are. Our middle child came 3 weeks early to be born on Leap Day of all days. She also had a score of two 10’s. The doctor laughed and said it was almost unheard of but she was very pink, noisy, and all ready face the world. ?
I laughed a little just reading how your doctor laughed too.
Yes, a perfect ten is highly improbable, like in ice skating. *wink* But not impossible. 🙂
FINALLY after searching for days I finally found what apgar score means! Thank you for your in depth explanation, it was very much needed!
You’re welcome, Colton! I’m glad I was able to help. Let me know if you have any other questions or are looking for something else. Best to you!
Thanks for sharing. I have never heard about it, but it makes so much sence to use a system like this. I wish I would have known when my son was born so I could have asked them about it. Marie
Well next time you have a little one coming along, you can certainly impress them with your wits and find out then. Thanks, Marie!
Wow, Sarah, I never knew there’s so much knowledge involved in monitoring new born baby’s state, I guess APGAR is a pretty good measurement. Not quite sure if my mom knew this when she gave birth to me HAHA!
I doubt my mother knew either. Every time I speak with mothers and grandmothers of the past generations, their knowledge base always seems a lot less then ours today. I always hear, “I never knew this when I had kids!” about almost EVERYTHING. It’s amazing how generations change. I’m just glad I’m in this one. 🙂
Thanks for your comment, Keye!
Huh, I’ve never really thought of this before. Thanks for sharing!
It can be quite enlightening. Thanks Angela!
I love that “Mostly I was bored as the doc was stitching me up” that’s so funny 🙂
I don’t actually remeber hearing anything about the APGAR score for either of my kids! I didn’t have two very traumatic births though and maybe just wasn’t aware of this happening. I wonder if I can find the score number in all my birth paperwork. I’m intrigued now!
I don’t know if it’s recorded in anything you receive, but I’m sure it’s in older hospital records for your children’s births. I’m sure you could ask. Thanks for your comment, Rochelle!
Wow! Very articulate post, it was definitely brilliantly written! You had some very knowledgeable information to share with the community about the APGAR score, it really helped me understand as a mother how a Baby’s physical state is rated 🙂 Awesome post, will definitely be looking forward to anymore improvements that you make to your site. 🙂
Thanks Floridalma! If you have any questions or are looking for something in particular, I am here to help.
I wondered what that score was!! My little boy had a score of 9 and I just figured that it must be good.
Nice to have it explained properly, thank you!
Amme 🙂
You’re welcome Amme! Feel free to share or ask any questions you like.
You are doing a great job with your site. Computers was kin of rare when I had my 4 children, so it wasn’t that easy to find information. I think it’s wonderful that you are educating everyone about everything that goes on when you have a baby. I had never heard of this test either. Keep up the good work.
Thanks Lureita. I appreciate your sentiments.
Thank you for sharing this valuable information.
As a communicator and speaker this website is a great source of material for me.
Once again hank you Sarah
What kind of a speaker are you, Santy? If you’re looking for anything in particular, let me know and I’m here to help! Thanks for your comment.
I’m so happy I came across this post! I love being educated about these things, and impressing the nurses sounds fun haha. I’m 26 and have been thinking about babies lately, and how I would want to have mine. So I may be premature (forgive the pun lol) but this is great information. Thanks for sharing!
Dear Angie,
That is wonderful that you’re already thinking about how you want to have your babies. Preparation and education beforehand makes such a HUGE difference for new mothers. I can’t imagine being one of those women that just floats through their pregnancy without even wanting to learn about what is going on in their bodies, and especially what is to come.
I am here to help and look forward to hearing from you in the future. Best of luck!
Thanks for sharing! Glad you shared this in depth of what does apgar score mean. This will be helpful to future Mother’s To Be. Great topic and love to visit your site often and hear about all the Natural Alternatives!
Thanks Angela. Let me know if you’re interested in any particular things.
It’s odd that the doctor wouldn’t tell you this unless you ask. I have 2 daughters and I’ve never heard of this before. I just asked my wifes cousin, a nurse, and she said they do that here too. I asked her why they don’t mention these results and all she said was they’ll tell you if they ask. I would of thought that if they preformed a test on your baby they’d tell you a bit about it. I’m sure they would if there’s a problem but just surprised that’s all. I wonder if they perform any other examinations I don’t know about. Thanks-for the info, I’ll be asking about this when we have our third child.
The apgar score is mainly gleaned from just simple observation, which is why I think it’s never mentioned. They’re not taking a sample or putting your baby under some sort of instrument, thus it can be conducted without much informing of the parents at all.
But yes, if there is every any issues, you would be informed, but not necessarily told that it was because of their apgar score. Absolutely ask about it with your next little one. It can actually be quite empowering when you understand more about how your baby is doing.
Thanks for your comment Dan! It’s always nice to hear from you.