Giving Birth with Confidence

Honoring the Apgar - What Does it Mean, Anyway?

Honoring the Apgar - What Does it Mean, Anyway?

Cara Terreri, LCCE, CD(DONA)

Yesterday, the Google Doodle honored Dr. Virginia Apgar, the American anesthesiologist and first female full-time professor at Columbia University who is most remembered for her invention of the Apgar Score, a simple first assessment test performed on babies all over the world to determine if they are in need of additional medical care.

Dr. Apgar was born in 1909, and grew to be a leader in the field of anesthesiology. As the rate of infant deaths in the first 24 hours in the 1930s and 40s remained high, Dr. Apgar started taking note of physical observations in babies in those first 24 hours that distinguished healthy babies from babies who were not healthy. Those observations officially became known as the Apgar Score in 1952.

Image source: Google Doodle

Today, the Apgar test, which is a non-invasive assessment, is routinely performed on babies at one minute after birth and again at five minutes after birth. If the Apgar Score is lower than 7 at five minutes, it is performed again every five minutes, up to 20 minutes. The Apgar Score assesses and records the following information about your baby:

A - Appearance. Specifically, doctors and midwives are looking at baby's color. Healthy babies will "pink up" shortly after birth, though it's very common to see blue hands and feet.

P - Pulse. Otherwise known as baby's heart rate, which should be over 100 beats per minute.

G - Grimace. This refers to baby's reflexes or responsiveness when providers suction their nose. A "good" response is a grimace, sneeze, or withdrawal.

A - Activity. This looks at muscle tone, which should show flexion and active motion.

R - Respiration. There's a reason why everyone wants to hear baby cry after birth -- crying is a good indication that baby is breathing well, which is what this part reviews.

Each of the five components of the Apgar will yield a score from 0 to 2, with 2 being the highest and indicating the most healthy. It's important to note that many babies do not receive perfect scores of 10, and scores less than 10 do not necessarily indicate future health issues. A score between 7-10 at one minute is normal and does not require medical attention. A score between 4-6 indicates that baby may need some help in the way of breathing -- additional suctioning or oxygen may be administered. A score less than 4 means that immediate medical help and life-saving measures is needed. A score of 7-10 at five minutes is still within the range of normal.