The Apgar test, named after Virginia Apgar, is a test given to babies at one minute and five minutes after birth. Dr. Apgar developed the Apgar test in 1952 after working in the obstetrical field as an anesthesiologist. Her system was developed to help doctors evaluate how baby was transitioning to life outside the womb. The scoring system is based on five observations: baby’s appearance (color), pulse, reflex response, muscle tone, and respiration. The Apgar score is a simple scoring system that any health professional can perform. Your baby’s Apgar score does not tell you anything about her overall health. It was designed to be an easy assessment to help doctors determine if baby needed resuscitation and prevent birth injuries from lack of oxygen or other complications.

 

Apgar Scoring System

 
 

0

1

2

Appearance

Color of baby’s body and extremities
Body is pale or blue
Body is normal color but hands and feet are blue
Body including hands and feet are nice and pink


Pulse
Baby’s heart rate
No pulse
Less than 100 beats per minute
100 beats per minute or higher


Grimace
Baby’s reflex response to suctioning with a bulb syringe
No response
Grimace
Active cry


Activity
Baby’s muscle tone
Limp or no movement
Some movement of arms and legs
Actively moving arms and legs


Respiration
Baby’s breathing
Not breathing
Slow or irregular
Breathing well/ strong cry

What does the Apgar score mean?

One minute Apgar score

The one minute Apgar score lets your doctor know if your baby requires immediate attention. A score of 7-10 generally means baby is in good shape and does not require any special medical help. If baby’s score is between 4-6 she may need some help breathing. Staff may rub baby vigorously with a towel to help stimulate her breathing. She may need her nose suctioned or she may need some oxygen to help her breath. If your baby’s Apgar score is less than four she may require immediate life saving measures to resuscitate her.

Five minute Apgar score

Babies are reevaluated at five minutes. Sometimes babies don’t score well right away but after a little suctioning, oxygen, or stimulation, they score better. If baby’s score is still below a 7, she may require special care. If baby’s Apgar is very low she may be sent to the neonatal intensive care unit for more intensive monitoring and medical attention.