What Is the Apgar Test, and How Does It Score Your Baby's Health?

Just seconds after your baby is born, she’ll take her first test... and that has you more than a little preoccupied. You know to wait for those lungs to belt out a healthy cry once your little one is born. But what exactly is the Apgar Test, and what else are the doctors looking for?

Crying is one of the criteria used in the Apgar Test – a test that provides a quick well-being assessment of the health of your newborn baby. Developed way back in 1952 by Virginia Apgar, an American obstetrical anesthesiologist, this test is still used up to this day.

Why Is the Apgar Needed?

The one-minute and five-minute tests will determine your baby’s well-being. The doctor will use this test to decide whether your baby is ok’ed for routine care after birth or if more medical attention and observation is needed. The first score is typically lower than the second because your baby is adjusting to life outside your womb.

When Is My Baby Tested?

Your baby will have two quick tests performed. A nurse, midwife, or doctor will give the tests. The first test is performed at one minute after birth. This one determines how well your baby is doing right after the birth process. An additional and identical test is performed at 5 minutes after birth to see how the baby is doing outside of your womb. Both tests are recorded.

What’s on the Scorecard?

The medical professional performing the test will be monitoring five different criteria and giving a score to each. These include:

Heart rate is tested by stethoscope.
0 – No heart rate
1 – Fewer than 100 beats per minute indicates that the baby is not very responsive.
2 – More than 100 beats per minute indicates that the baby is vigorous.

Respiration is tested by observing the chest and the strength of the crying.
0 – Not breathing
1 – Weak cry – may sound like whimpering or irregular breathing
2 – Good, strong cry

Muscle Tone is judged by the amount of flexion in the arms and legs.
0 – Limp
1 – Some flexing (bending) of arms and legs
2 – Active motion

Reflex response is tested by gently tapping the heel of the foot.
0 – No response to stimulation
1 – Grimace during stimulation
2 – Grimace and cough or sneeze or vigorous cry during stimulation

0 – The baby’s entire body is blue or pale blue
1 – Pinkish color on the body but with blue hands or feet
2 – The entire body is pink
*In non-Caucasian babies, the mucous membranes of the mouth, lip and tongue are observed for central cyanosis, which is a bluish-purple color, meaning there’s not enough oxygen.

What’s a Good Apgar Score?

The higher the score, the better your baby is doing after birth. Ten is the highest score possible, but rarely do any babies get a 10 simply because a point is lost for blue hands and feet, which are typical when the first and second tests are performed. Other factors leading to a lower score are lack of vigorous crying. Some babies are naturally more quiet, which isn’t a cause for concern. Plus, if you’ve had a C-section, a difficult birth, or there is fluid in your baby’s airway, it could contribute to a lower Apgar score.

A good one minute score is between 7-10. A score lower than 7 usually signifies the baby needs medical attention. Sometimes, your baby just may need a little more help adjusting to life outside the womb. It is quite a drastic change after all!

A score below 7 after the five minute test will require continued monitoring and testing for up to twenty minutes. Your baby may need more oxygen, and clearing of the airways to help with breathing. Physical stimulation to get the heart beating at a strong, healthy rate may also be needed.

Note that lower than normal scores don’t necessarily mean there will be permanent health issues.

Apgar for Mom’s Health, Too

Recent research at St. Michael’s Hospital, Toronto, Canada found that when babies had a low Apgar score, moms had 9 times higher risk of ICU admission than those whose baby had a normal Apgar score.

Among babies whose Apgar scores were in the intermediate range, 12.3 out of 1000 moms were admitted to the ICU. For those whose scores were in the lower range, 18 out of 1000 moms were admitted. This may prove to be a good metric to gauge moms’ health after birth too.

Do these tests make you nervous as heck or what? Let me shift your focus by asking: What restricted food are you excited to devour once baby is born? Share with us!

Tags : pregnancy   newborns   

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