Why you should know about Dr Virginia Apgar

Google are celebrating Dr Virginia Apgar’s birthday today, find out why her work is important to you and your baby.

Google Doodle illustration of Dr Virginia Apgar with a drawing of a doctor's face next to a rosey cheeked newborn

Blog by Tommy's midwife Kate, 07/06/2018

We love that Google are celebrating what would have been Dr Virginia Apgar’s 109th birthday today. The Apgar score she developed in 1952 is still used to assess the wellbeing of a baby in the first few minutes after they have been born.

What is the Apgar score?

The Apgar score is used by midwives to check for five different signs to find out how well your baby is just after they are born:

  • muscle tone
  • heart rate
  • reflex response
  • colour
  • breathing. 

This score is recorded when your baby is one minute old and then again at 5 minutes old.

Does the midwife need to take the baby away to do the assessment?

No, your baby can be placed directly on you for some skin-to-skin as soon as they are born, and delay cord clamping until it stops pulsating. The midwife can check baby when they are in your arms as this is the best place for them to be.

What does the score mean?

Each of the five signs are scored between 0–2, with 2 being the best score. This is added together to get a total out of 10. Most babies don't get a 10, especially after one minute, as it is normal for their hands and feet to be a bit blue.

Sign

Score

 

0

1

2

Heart rate

Absent

Slow (less than 100bpm)

Fast (more than 100bpm)

Breathing effort

Absent

Slow and irregular

Normal rate, crying

Muscle tone

Limp

Some movement (flexion) in arms and legs

Good tone and active movement

Reflexes

No reflex response

Facial movement with stimulation

Crying/coughing/sneezing

Colour

Pale blue

Body pink, arms and legs blue

Pink all over including hands and feet

What if my baby has a low score?

Sometimes your baby may have a low score, often they are just in a bit of shock from the birth. Usually they recover quickly with plenty of skin-to-skin and some stimulation, such as rubbing their back, to help with their breathing and bring up their score. 

Less commonly, a baby may need some extra help with their breathing, in which case your midwife and neonatal doctor will do some further work and assessments to support your baby.

The Apgar score is only an assessment of how your baby is at that immediate time, having a low score is no indication of your baby’s future health and wellbeing.

More about after the birth

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  • Mum playing with baby.

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