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What is an Apgar Score and How Does it Affect My Newborn?

Apgar scores are a crucial tool used to monitor the health of newborn children. Children that receive low Apgar scores at birth should receive prompt medical treatment, and when a doctor fails to provide this treatment, they could be responsible for the newborn’s injuries and bad health outcomes.

An Apgar score is a test given to newborn babies immediately after birth. The test examines the baby’s muscle tone, heart rate, and other signs to determine if emergency medical care is required. If your doctor failed to act when your baby received a low Apgar score, it can affect your newborn by causing or exacerbating severe birth injuries.

If your newborn was injured because your physician did not respond properly to a low Apgar score, get help pursuing the compensation you deserve. Contact our experienced Baltimore birth injury lawyers by calling Rice, Murtha & Psoras at (410) 694-7291 for a free case review.

What is an Apgar Score?

Apgar scores assess the clinical status of newborns. The score serves to check a baby’s health using the following five factors:

  • Appearance/Skin Color
  • Pulse
  • Grimace Response/Reflex
  • Activity
  • Respiration

Scores are given from 0 to 2 based on initial observations of the child. Babies that score higher on the Apgar assessment are considered to be in good health. Lower scores do not necessarily mean your baby is unhealthy, but may mean that your baby needs immediate medical attention such as the clearing of airways to assist breathing.

The test is first given after 1 minute. Low scores are typically common after 1 minute, particularly in babies born via cesarean section, prematurely, or after a complicated delivery. After 5 minutes, the test will be administered again. If the newborn still receives a low score after five minutes, the baby must be closely monitored.

If your baby received a low Apgar score and your doctor did not give specific medical advice regarding your newborn’s score, our birth injury lawyers can help pursue monetary damages.

How is the Apgar Score Determined?

There are five factors that have been developed to determine your child’s Apgar score. Scores are given from 0 to 2, with low scores potentially indicating a birth injury. The following factors are examined to determine if a baby is healthy or if emergency treatment is required:

Appearance/Skin Color

Doctors or nurses will judge a baby’s appearance based on his skin color. If a child has blueish gray or pale skin, they will receive a low Apgar score. Blue or gray skin may indicate the newborn is lacking oxygen. Babies will receive a high Apgar score if their skin is pink, the appropriate color.


Your child’s heart rate will also be examined when determining their Apgar score. A baby with no heart beat will receive a score of 0. Children whose hearts are beating less than 100 times per minute will receive a score of 1. Unfortunately, some healthcare professionals fail to check the heartbeat of newborns immediately after birth. When newborns’ pulses are not monitored, serious medical problems can develop. Victims of such injuries can contact our birth injury lawyers to discuss the legal options available to them.

Grimace Response/Reflex

The grimace response is measured by checking a child’s reflexes. A lack of response to physical stimulation could indicate that your baby’s airways are closed. Newborns with no reaction to the grimace response test will receive a score of 0. The score of 1 will be given to babies who lack stimulation but cry weakly. High scores are given to newborns who pull away, cough, sneeze, or vigorously cry.


Additionally, activity is measured by examining your newborn’s muscle tone. If your child has limp, loose, or floppy muscle tone, it will receive a low activity score. Failure to check your child’s muscle tone can leave serious issues untreated. If your newborn was injured because your doctor failed to check their activity level, you may contact our birth injury lawyers for help seeking compensation.

Respiratory Effort

Lastly, when determining the Apgar score, your physician should give your child a score between 0 and 2 for respiratory effort. Signs of low respiratory effort may indicate your baby has been deprived of oxygen. Newborns that are not breathing at all will receive a score of 0. A child will receive a score of 1 for a slow or irregular breathing rate, while babies that cry well with normal respiration will receive a score of 2.

Why Did My Newborn Receive a Low Apgar Score?

Most of the time, babies receive low Apgar scores because they were deprived of oxygen. It is crucial that the baby breaths properly in the first moments out of the womb. The following are a few of the ways your child could be deprived of oxygen before, during, or after delivery:

  • Cesarean section delays or mistakes
  • Pulling or twisting a newborn during delivery
  • Deliveries using forceps
  • Preterm delivery
  • Failure to monitor a fetal heartbeat
  • Failure to provide oxygen to a newborn when required
  • Infection
  • Arrested or prolonged labor
  • Umbilical cord issues
  • Uterine rupture
  • Placental abruption

Your baby may have suffered some of the aforementioned conditions because your doctor committed medical malpractice. If your child’s issue was left untreated and would have been detectable through routine care, your doctor may be liable for your newborn’s injuries. You can contact our experienced birth injury lawyers for help assessing the validity of your lawsuit during a free case review.

What are Assisted Apgar Scores?

Newborns born with low Apgar scores are more likely to require resuscitation. In some cases, resuscitation is needed before an Apgar score can be given. If your child goes through a resuscitation, the Apgar score given during resuscitation will be different than the one given to a baby breathing on their own.

Accordingly, assisted Apgar scores may be administered to newborns who have been resuscitated. This score is adjusted to account for the child’s resuscitation.

What if My Doctor Failed to Act After My Newborn Received a Low Apgar Score?

Newborn children who do not receive prompt medical treatment after receiving low Apgar scores can develop severe birth injuries. Accordingly, in such cases, doctors can be held liable for injuries caused by their failure to act.

Babies with lower Apgar scores require more assistance to adjust to life outside their mother’s wombs. Any baby who receives a total score lower than 7 should receive attention right away. Our birth injury lawyers can help hold doctors responsible for not properly responding to low Apgar scores.

If Your Newborn Was Injured Because Your Physician Made an Error When Reviewing your Baby’s Apgar Score, Our Lawyers Can Help

If your newborn was given a low Apgar score and your physician failed to act, seek assistance from our experienced Maryland personal injury lawyers by calling by calling Rice, Murtha & Psoras at (410) 694-7291 for a free case review.