APGAR Score And Chart - Everything You Need To Know

APGAR Score And Chart

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The moment of birth is a miracle of nature. The one moment in time when a new life takes its first breaths. For women, it is the time to embrace a new role – that of a mother.

But for doctors, the moments following birth are devoted to the well-being of the new mother and her newborn baby. One of the tools doctors use to measure the baby’s stability post birth is the APGAR Test.

This quick test is conducted one and five minutes after birth. The first test is done to determine how the new baby tolerated the birthing process. The second one, done five minutes after birth, checks how the baby is doing outside her mother’s womb.

Sometimes, a third test is also done 10 minutes after birth. But this is done only in rare cases.

How Is The APGAR Test For Babies Conducted?

A doctor, midwife, or nurse can conduct this simple test. The APGAR test checks a baby’s:

  • Breathing
  • Heart rate
  • Muscle tone
  • Reflexes
  • Skin color

Each category gets a score between 0 – 2.

1. Breathing:

  • If the newborn is not breathing, the score is 0.
  • If the newborn’s breathing is slow and irregular, she gets a score of 1.
  • If the newborn is crying, she’ll get the highest score – 2.

2. Heart Rate:

  • In the absence of a heartbeat, the newborn is given a score of 0.
  • If the newborn’s heart beats at a rate of less than 100 beats per minute, she’ll get a 1.
  • The doctor will give a score of 2 if the newborn’s heart rate is more than 100 per minute.

3. Muscle Tone:

  • A newborn with loose and floppy muscles gets a 0 in the APGAR test.
  • If there is a little bit of muscle tone, the newborn gets a 1.
  • If the newborn is active, she will get a score of 2.

4. Reflexes (On Being Pinched):

  • If a newborn does not react to touch, she scores a 0.
  • If the newborn reacts with a grimace, she gets a score of 1.
  • If she reacts vigorously with a good cry, she scores a 2.

5. Skin Color:

  • If your baby’s skin has a blue pallor, she’ll get a zero.
  • If her body is pink and the hands and feet are blue, your newborn will get a 1.
  • If your newborn’s entire body is pink, she’ll get a score of 2.

A Sample APGAR Score Chart:

Sign0 Points1 Point2 Points
Activity (Muscle Tone)AbsentArms and Legs FlexedActive Movement
PulseAbsentBelow 100 bpmAbove 100 bpm
Grimace (Reflex Irritability)No ResponseGrimaceSneeze, cough, pulls away
Appearance (Skin Color)Blue-gray, pale all overNormal, except for extremitiesNormal over entire body
RespirationAbsentSlow, irregularGood, crying


What Does The Test Scores Mean:

If a newborn scores between 7 and 9 on the APGAR test, she is thriving! It is very rare to get a score of 10 though. This is because almost all newborns take birth with blue extremities (hands and feet).

If a newborn gets less than 7 in her APGAR test, she needs medical attention. The major causes for low APGAR scores include (1):

  • Trauma during birth
  • C-section
  • Fluid in the baby’s airway
  • Substance abuse by mother (2)

Treatment Offered To Newborns With Low APGAR:

If your newborn has a low APGAR, her doctor may offer the following treatment options:

  • She may be kept under ventilation to get adequate oxygen.
  • Her airways may be cleared to help her breathe more easily.
  • Helping the heart beat normally through physical stimulation.

Most newborns with low APGAR during the first test get normal scores during the second one. But these scores do not indicate long-term outcomes. A newborn with a low APGAR may go on to have neurological problems later n life, while 75% of children with cerebral palsy get normal APGAR scores at 5 minutes (3). Only an expert can analyze these scores correctly.

So, don’t read too much into your newborn’s APGAR score! Leave that to the experts. Spend your energy on nurturing your little one instead!

How much did your baby score in her APGAR test? Share with us in the comments section below!

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