The Newborn Apgar Test

The Apgar score is a test given to newborns soon after birth. This test checks a baby’s heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed. The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth.

As soon as your baby is born, a delivery nurse will set a timer (stopwatch) for one minute and another for five minutes. When each of these periods is over, a nurse or doctor will do the first “tests” on your baby, called tests of

This Apgar scoring system (named after its creator, Virginia Apgar) helps your doctor estimate your baby’s general condition at birth.

What does the Apgar test measure?

This test evaluates your baby across a number of criteria.

This test cannot predict how healthy you will be when you grow up or how you will develop. It also doesn’t indicate how smart you are or what your personality is like. However, it alerts hospital staff if the baby is more sleepy or slower to respond than normal and may need assistance as he adjusts to his new world outside the womb.

How is the Apgar score assigned?

Each characteristic receives an individual score: two points for each of the five categories if all goes well. Then all the scores are added together.

For example, suppose your baby has a heart rate greater than 100, is crying vigorously, actively moving, grimacing, and coughing in response to the syringe, but is bluish in colour. In this case, it would have an 8 on the Apgar scale: two points lower because it has a bluish colour and not a pink one.

Most newborn babies have Apgar scores greater than 7. Because their hands and feet remain bluish until they are quite warm, very few have a perfect score of 10.

The table below summarises the Apgar Scoring System

• If your baby’s Apgar score is between 5 and 7 in one minute, you may have had some problems during birth that reduced the oxygen in your blood. In this case, the hospital nurse will likely blot you dry with a towel while oxygen is placed under your nose. This should get you to begin taking deep breaths and improve your oxygen supply so that your five-minute Apgar score is between 8 and 10 total.

• A small percentage of newborns have Apgar scores less than 5. For example, babies born prematurely or by emergency cesarean section are more likely to have low scores than babies who are born normally. These scores may reflect the difficulties the baby had during labor or problems with the heart or respiratory system.

What if your baby’s score is too low?

If your baby’s Apgar score has very low scores, a mask may be placed over his face to pump oxygen directly into his lungs.

If they are not breathing on their own within a few minutes, a tube may be placed into their windpipe, and fluids and medications may be given through one of the blood vessels in the umbilical cord to strengthen the heartbeat.

If your Apgar scores are still low after these treatments, the baby will be taken to a nursery requiring special care for more intensive medical care. Thankfully, this is a rarity but does sometimes happen.