Shortly after birth, your baby will be weighed, measured and be given an Apgar score at one, five, and ten minutes after birth


The Apgar score is designed to quickly determine the need for medical intervention in the first few minutes after birth. At one minute and five minutes after birth, a physician or nurse assigns a score between zero and two for each of the following characteristics of the newborn: appearance (A), pulse (P), grimace (G), activity (A), and respirations (R). The first Apgar score (0--10) is given at one minute of life and is thought to represent the baby’s initial response to the stress of labor/delivery and any anesthesia. 

If the one-minute score is 6 or less, the baby requires some level of immediate intervention, ranging from brisk drying with warm blankets, to suctioning the mouth and nose, to full CPR and intubation (inserting a breathing tube into the airway) if necessary. The five-minute score represents the baby’s response to any resuscitation given after a low one-minute Apgar, or, if the one-minute score was reassuring (7 or above), the baby’s own adjustment to the ‘outside world’. Apgar scores can be assigned at five-minute intervals (at 10, 15, 20 minutes etc.) until medical interventions are successful at normalizing the baby’s score above 7.  A low one-minute Apgar score is not an indicator that the child will have long-term health problems, especially if the score improves by the five-minute score.

APGAR score

The purpose of the APGAR score is to assess the general condition of the newborn immediately after birth and to recognize complications and treat them accordingly. The Apgar score is assessed at 1 minute, 5 minutes and 10 minutes after birth. It is based on 5 factors, each scoring 0--2, with a total score of 10 being the best:

	Sign	0 point	1 point	2 point
A	Appearance	Baby is blue or pale	Body pink and extremities blue	Pink over entire body
P	Pulse	Absent	Below 100 beats per minute	Above 100 beats per minute
G	Grimace	No response	Grimace	Pulls away, coughs, sneezes
A	Activity	Baby is limp	Some movement of arms and legs	Active movement
R	Respiration	Absent	Slow, irregular	Strong, regular or crying

The Apgar scores are designed to signify the need for further medical intervention in the first minutes of life, not to predict long-term outcomes for the child. Premature infants are at a higher risk than term or near-term babies of not tolerating delivery well, and often require medical intervention and prolonged monitoring in special care nurseries.   

By Dr. Laura Thomas Blanchard