APGAR: Baby’s First Test

Your baby will have his first test soon after birth. The APGAR test was designed by Virginia Apgar in 1952 as a way to evaluate a baby’s condition just after birth. The test is done at one and five minutes after the birth to assess the baby and determine if any medical attention is needed.

The word APGAR is an acronym. It stands for Activity, Pulse, Grimace, Appearance and Respiration. The baby is scored from zero to two under each category. The scores are totaled to give the overall score on the test.

An APGAR score of seven to ten is considered normal. A score of four to seven may indicate a need for medical attention. A score of three or under indicates that the baby needs immediate resuscitation.

A lower score at one minute doesn’t necessarily mean there is a problem. The baby may have a normal score at the five minute test. If the score remains low after ten or fifteen minutes, there may be a neurological problem.

The A stands for Activity. This is describing the baby’s muscle tone. A score of zero means there is no activity or muscle tone. A score of one indicates the baby is flexing his arms and legs. If the baby is actively moving, a score of two is given.

The P stands for Pulse or heart rate. If there is no pulse, the score is zero. A score of one indicates a heart rate of less than one hundred beats per minute. A score of two indicates a heart rate above one hundred beats per minute.

The G stands for Grimace or reflex irritability. If there is no response from the baby, a score of zero is given. If the baby grimaces and cries when stimulated, this is a score of one. If the baby pulls away, he is given a score of two.

The second A stands for Appearance. How does the baby’s color look? If the baby is blue or pale, a score of zero is given. If the baby has a normal color, but blue in the extremities a score of one is given. If the baby has normal color, he is given a score of two. Most babies are a bit blue in the extremities immediately after birth. This is normal and generally resolves quickly.

The R stands for Respiration. If the baby isn’t breathing, a score of zero is given. Slow or irregular breathing is given a score of one. Good respiration and crying is given a score of two.

Don’t panic if your baby doesn’t score a perfect ten on the APGAR scale. The test is not diagnostic. It won’t show whether there is a problem with your baby. It just means the baby may need a bit more attention. Your doctor will discuss the baby’s score and the need for additional testing, if a problem is suspected.

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About Pattie Hughes

Pattie Hughes is a freelance writer and mother of four young children. She and her husband have been married since 1992. Pattie holds a degree in Elementary Education from Florida Atlantic University. Just before her third child was born, the family relocated to Pennsylvania to be near family. She stopped teaching and began writing. This gives her the opportunity to work from home and be with her children. She enjoys spending time with her family, doing crafts, playing outside at the park or just hanging out together.