Is Baby OK During Labour?

Apgar Scores.

apgar scoreWhat are Apgar scores? What do the scores mean?

Dr Virginia Apgar was a remarkable physician who created an easy, effective way of evaluating a newborn baby. In 1949, she came up with five points to recognise distress in a newborn baby. By 1952 she was presenting the Apgar scale in its present form.

At the moment the baby is born, a timer is set.

At one and again at five minutes, the baby is evaluated and a score given.

This score helps the nurse, physician, and midwife to evaluate whether the baby needs assistance in adapting to the outside world.

This is the way the Apgar scores are given:

Score 0 1 2
Heart Rate Absent <100/minute >100/minute
Respirations(breathing) Absent Slow, irregular Good, strong cry
Muscle Tone Limp Some flexing of arms and legs Active motion
Color Completely blue or pale Body pink with hands/feet blue Completely pink
Reflex* Absent Grimace Grimace and cough or sneeze




*The reflex score is based upon the reaction the baby has to pinching his or her nose.

When the score at one minute is seven or lower, it suggests that the baby may have experienced some difficulties during labour or the birthing process, that lowered the oxygen in its blood. We say ‘may’ because there are many babies with lower Apgar scores who have completely normal oxygen levels, and for one reason or another simply get vigorous a little later.

Maximum score is 10, and this is very unusual at 1 minute. Seven or over is great.

Most babies take a few minutes to warm up to pink! Dark skinned babies don't show the change very well on the skin, so places like the eyelid or inside the mouth are used. Some hospitals omit the colour score simply for these reasons, in which case the maximum score would be 8.

A lot of myth and mystery surrounds what this score means. Parents get nervous that a low Apgar score means the baby will have problems immediately, or later in life. This is not the case, just as it is not true that having a high score eliminates the possibility of future difficulties. The score's only purpose is to alert the midwife to the fact that the baby may need assistance. It also allows the midwife to monitor the effectiveness of any interventions. If the score goes up, it implies the interventions are working.

A lot of research has been done on the Apgar score to see if it can be used to predict those who will have problems such as learning difficulties, cerebral palsy, seizures, etc. These studies have shown it to not be reliably predictive, proving that the score is great for what Dr Apgar originally intended it to be and nothing else: a quick, easy way of figuring out if a baby needs help.

Also see

Children's Illnesses 3
Includes ideas for nervous or sleepless children

Crying Babies

More help for babies who cry a lot.

Breastfeeding: Natural and Homeopathic Remedies
Tips to encourage breast milk, and more

BACK TO Pregnancy and Childbirth Intro page and full list

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