There you are sitting in the hospital having just given birth to a beautiful baby when you are told by the nurse that the baby received a 10 both times on the APGAR test. You respond, “The What?” And the nurse replies, “The APGAR test, your baby’s very first test!”
So many people with children still do not know what in the world APGAR even stands for. Most new parents just know that their child got a 10, or maybe a 7 the first time and then a 9, or maybe they are not even aware that their baby was tested at all. There are millions of babies born each year in the US and most of them will receive an APGAR test at the first minute after they are born and again at 5 minutes after birth. Seems important Right? So why do most people not know what this is?
The APGAR test was developed by a woman named Virginia Apgar in the early 1950’s as a means of evaluating newborns immediately after birth. The newborn scores Zero, One, or Two points for each of five categories with a total of 10 points possible. A score of 10 yields a healthy baby while a score of anything less than 6 could be a sign of problems.
The APGAR is an acronym that stands for appearance, pulse, grimace, activity, and respiration. Each of the five categories are tested and scored to arrive at the total which determines the general health of the newborn. Keep in mind that the APGAR is just one of many tests that your newborn will endure in the hospital over the hours following delivery.
Appearance: When examining the newborn’s appearance the nurse or doctor is paying close attention to the color of the newborn baby. If the baby is very pale or blue, he will not score any points for appearance. A baby with a pink body and blue arms or legs will receive a score of 1 point for appearance. For a perfect score of 2 points in appearance the newborn must be pink all over.
Pulse: The pulse examination is a determination of the baby’s heartbeat. An undetectable heartbeat will warrant a score of zero points for Pulse. In order to score maximum points for pulse the newborn baby must have a heartbeat that is over 100 beats per minute. Below 100 beats per minute will receive a score of 1 point as long as there is a heartbeat present.
Grimace: Grimace is otherwise known as the reflex irritability of the infant. When the new born is stimulated does he let out a lusty cry? If so he gets 2 points for Grimace. If the newborn only grimaces when stimulated but does not cry then he will only receive one point in this category. A newborn baby that does not show any response when stimulated will not receive any points in the grimace category.
Activity: Activity is an examination of the newborn’s muscle tone and use. For a newborn to score maximum points in the activity category then the baby must be very active and show lots of movement of his extremities. In order to receive at least one point the newborn must show some movement of the extremities while no movement or extremely weak activity will obtain a score of zero for this category.
Respiration: If the newborn is not breathing then he will not get any points in this category. A baby whose respiration is slow or irregular will receive only one point for respiration. Doctors look for a crying and steadily breathing baby with good respiration to receive the most points for this category.
Babies whose scores are above 6 points typically are just fine. A newborn that scores between 4 and 6 points may need resuscitation such as suctioning of the airways and additional oxygen but will usually be ok with some additional monitoring. Any newborn that scores 4 or less on the APGAR is susceptible to life threatening complications and will likely require dramatic lifesaving techniques in order to survive.