Beyond APGAR

The very first test your child will ever have is so routine that you may miss it. The APGAR scoring method quickly provides doctors and midwives with a way to determine your baby’s health in those important minutes right after birth.

“I don’t remember much about the actual test being done, only being given the results,” says Christine Stewart, a mother of one in Aurora, Ontario. “There is much intensity in those first few moments of post-delivery. But, even though you’re in a fog you just want to know as quickly as possible that your baby is healthy. That’s the good thing about the APGAR. It’s done so quickly.”

What is the APGAR score?
Developed in the 1950s by American obstetric anaesthesiologist, Dr. Virginia Apgar, the scoring method was the first standardized approach to evaluating a newborn’s transition to life outside the womb.

The factors
There are five factors that the medical professional use to assess your baby’s vital signs and physical responsiveness: Heart rate, breathing, muscle tone, reflexes and skin colour. APGAR scores are out of 10, with each factor assigned a range from zero to two.

Double the testing
The test is given at two intervals – the first is administered a minute after birth and then the second five minutes later. This way, the medical professionals can check the baby’s progress to see if he or she is improving following the first test.

The rare perfect 10
The majority of babies score between seven and 10 after the first test and are generally considered to be in good health. However, many babies need a little encouragement to come around after birth and a lower first score is not uncommon. There are also many factors that can contribute to a lower score, such as a premature birth, post-term delivery, a difficult labour, meconium aspiration, underlying health conditions in the mother, as well as a multitude of other variables.

What happens following a low score?
“If a baby’s APGAR score is low it implies medical attention is needed, either suctioning, stimulation, oxygen or resuscitation and close observation,” says Dr. Cathryn Tobin, paediatrician and author of The Lull-a-Baby Sleep Plan. If the baby receives a second low score the medical team will go into action. “A baby may require medical intervention, such as oxygen by mask or incubation, or even resuscitative measures and close observation if the score is very low, 0 to 3,” says Dr. Tobin.

Your baby’s still a 10!
Don’t fret if your baby is deemed healthy, but initially received a low score. The APGAR score simply tests how your child was doing following delivery, but is not designed to predict longterm development or intellectual abilities. “I’m sure it could be alarming if you have a difficult or early delivery that could make the initial score low, but we were fortunate,” says Stewart. “As with everything about becoming a parent it helps to keep things in perspective.”