The Apgar Test


What is it, anyway?  You might hear parents bragging about their kid’s Apgar scores….is this some pre-K aptitude test that you need to worry about?  Well, considering preschools now have waiting lists that you need to get on while your child is in the womb, it wouldn’t be far-fetched.  The Apgar is actually the first “test” that your child will undergo, and gives a picture of how well your newborn is adapting to extrauterine life immediately after birth.

When is the test performed?  Twice.

  • At one minute after birth
  • At five minutes after birth

Why do we do the Apgar test?

The primary purpose of the test is to help nurses and doctors determine if your baby’s breathing and heart function is ok. 

The APGAR assesses five things:

  1. Activity
  2. Pulse
  3. Grimace
  4. Appearance
  5. Respiration

Each of these is given a score of 0-2, with 0 being not so great, and 2 being the best.

Here’s what the nurses and docs are looking for and how they score your baby:

ACTIVITY: they’ll be looking for muscle tone and how much your baby is moving around

0 no movement

1  some flexion of arms and legs

2 active motion

PULSE (HEART RATE): a baby’s heart rate should be between 120-160 beats per minute

0 no heart rate

1 less than 100 beats per minute

2 greater than 100 beats per minute


0 no response to being suctioned with the blue bulb

1 makes a grumpy face

2 makes a really grumpy face, along with a cry, cough, or sneeze

APPEARANCE (SKIN COLOR): a nice, pink skin color shows your baby is oxygenating well

0 blue

1  pink, with blueish hands and feet

2 pink all over


0 not breathing

1 slow and irregular, weak cry

2 breathing well, robust crying

Numbers are then totalled, with a newborn being able to receive a score of 0-10.  The higher the score, the better the baby is doing.  A score of 7-10 is optimal.  Anything less than this means it’s time to intervene. 

What can cause a low score?

  • Traumatic birth
  • Fluid trapped in baby’s lungs
  • C-section: vaginal birth helps to push fluid out of the lungs

A low score at one minute usually improves by five minutes.  If it doesn’t, your baby will probably be transferred to the Neonatal Intensive Care Unit for some TLC.  Most of the time, babies with low scores do just fine and have no long-term effects, so nothing to fret too much about! 


For more info on the APGAR, check out this video from