What it is: The Apgar test tells doctors how healthy your baby is in the first moments of life and whether he needs any medical help — and if he does, how soon he needs it. Apgar is an acronym, standing for the following criteria:
Appearance (skin color)
Pulse (heart rate)
Activity (muscle tone)
Respiration (breathing effort)
A doctor, midwife, or nurse will assign your newborn an Apgar score based on these five criteria. Each one is scored from 0 to 2, with a total of 10 possible points. The higher the Apgar score, the better your baby is doing. A score of 7, 8, or 9 is normal, while a baby who scores 1 to 6 needs some medical attention. (Babies rarely get a perfect 10 because most of them are born with blue hands and feet!)
Here’s how the scoring works in Apgar tests:
Is your baby’s skin pink (healthy) or blue (unhealthy)?
Pale blue: 0
Pink body, blue extremities: 1
Pink all over: 2
Using a stethoscope, the doctor or nurse will listen to your baby’s heart.
No heartbeat: 0
Heartbeat fewer than 100 beats per minute: 1
Heartbeat more than 100 beats per minute: 2
Reflex irritability, also called the grimace response, is how your baby reacts to stimulation like a light pinch (don’t worry, it doesn’t hurt).
No reaction: 0
Grimacing with a cough, sneeze, or vigorous cry: 2
This category measures how your baby is moving around.
Loose and floppy muscles: 0
Some muscle tone: 1
Active motion: 2
Here the doctor, midwife, or nurse will check how well your baby is breathing.
No breathing: 0
Slow or irregular breathing: 1
Strong crying: 2
When it’s done: All babies get at least two Apgar scores in the delivery room. The first tests will be done one minute after birth to see how well your newborn made it through the delivery process. At five minutes after birth the test will be repeated to see how he’s doing now that he’s out in the world. Most low scores at one minute are normal five minutes later. Once in a while, a baby with a low score at five minutes may get tested again at the ten-minute mark.
Why it’s done: To see whether your baby needs help breathing or is having heart problems. If your baby gets a low score on his Apgar test, he may need oxygen or have his airway cleared out; or he may need some physical stimulation to get his heart rate up. Most of the time, a low score is the result of a difficult birth, a C-section, or fluid in the baby’s airway.
Is it standard? Yes, every baby should get two Apgar scores.
Should you ask for it? You won’t have to.
What you need to know: The Apgar test started in the 1950s to check whether babies needed resuscitation after their mothers got anesthesia during delivery. Although it was used in the past to predict whether a baby would survive or have neurological problems, today your baby’s Apgar test score isn’t considered a sign of anything other than how he’s doing during the first few minutes of life.