APGAR, birth center, birth team, First Baby, Home Birth, hospital birth, Midwife, Midwife's Assistant, Newborn, Nurse, OB, Pediatrician, Postpartum

Testing Tuesday: APGARS!

Baby’s First Test: The APGAR

APGAR scoring was developed in 1952 by Dr. Virginia Apgar who noticed that providers didn’t have a standardized way of evaluating a baby after birth. She created the APGAR score (a handy acronym that is also her name) to get everybody on the same page. Since then, the APGAR score is used the world over, both in-hospital and out!

Your provider is looking at: 

Activity (tone)

Pulse (heart rate)

Grimace (reflex irritability)

Appearance (skin color)

Respiration (crying/breathing)

Each aspect can be scored 0, 1, or 2, all added up to a total score out of 10. Baby is evaluated at 1 minute, 5 minutes, and, if necessary, 10 minutes.

Baby can usually stay on your chest for assessment. Your provider probably won’t announce the APGAR out loud, so you can ask for baby’s score if you are worried.

A baby who scores low at or before one minute will need rescue breathing or other measures to improve chances of survival. A baby who scores high won’t need to be anywhere but in their parents’ arms. A borderline APGAR baby may be observed more closely on your chest & will be stimulated, suctioned, or given postural drainage. 📊 When a baby needs resuscitation in the first minute, APGAR scoring can tell us how a baby is improving over time.

Generally, a baby who scores less than 5-7 at 5 minutes or less than 7 at 10 minutes may benefit from a transition to the NICU to reduce risks of long-term neurological challenges.

APGAR scoring isn’t perfect; studies vary about its ability to predict long-term morbidity and mortality. But it helps all members of the birth team to make decisions together. It also helps in-hospital and out-of-hospital care providers to speak the same language about your baby’s best plan of care.

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