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Apgar Score: Your Newborn's First Test

Shortly after being born, your baby will be given their first test: the Apgar score. This test is done to evaluate how a newborn is adjusting to life outside the womb. It measures your baby's heart rate, respiratory effort, muscle tone, reflex irritability, and color. If the score is too low, healthcare providers know that your child may need some additional help.

What Is the Apgar Score?

If you've had a baby before, you might have heard the doctor or nurse speak of your baby's Apgar score. In many cases, though, the baby's Apgar scores are never even mentioned to the parents, especially if the scores are normal. The Apgar score is a way to quickly assess a newborn baby, based on five easy-to-observe signs.
Birth is more than just a physical passage through the birth canal. It is a major physiological transition that requires multiple significant changes to happen very quickly in order for a baby to go from life inside the womb (living in warm amniotic fluid with all oxygen and nutrients supplied by the mother) to life outside (requiring breathing, temperature regulation, and other changes).
Usually, these changes happen right on schedule, but not always. The Apgar score helps healthcare providers make quick decisions about which babies need extra help or monitoring, and helps to accurately and consistently record how well a baby is adjusting to life outside of the womb.

How Is the Apgar Score Calculated?

There are five components of the Apgar score, as follows:
  • Heart rate (this one is fairly self-explanatory)
  • Respiratory effort (how well the baby is breathing)
  • Muscle tone (this includes whether or not the baby is moving)
  • Reflex irritability (how the baby responds to stimulus, such as a light pinch)
  • Color (rates how well blood is flowing to the body, including the arms and legs).
Apgar scores should be taken at least twice: once one minute after the baby is born, and a second time five minutes after the baby is born. Each of the five components is given a score of 0, 1, or 2 points, and the points are then added together. A higher score is better. A crying, moving baby who responds vigorously to being lightly pinched and has a nice pink color throughout the body will get a score of 10.
If a baby's five-minute score is low, healthcare providers will usually continue scoring the baby every five minutes as the baby's condition improves, stabilizes, or deteriorates.
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