Apgar Score Calculator
This Apgar score calculator adds up the five signs a newborn is checked for one and five minutes after birth – skin colour, heart rate, reflexes, muscle tone and breathing, each with 0, 1 or 2 points. Example: a baby with a pink body but blue hands and feet and full marks everywhere else scores 1 + 2 + 2 + 2 + 2 = 9 of 10, which counts as reassuring at five minutes.
How it is calculated
The Apgar score is a quick check of a newborn’s condition directly after birth. Five signs are each given 0, 1 or 2 points and added up, so the result lies between 0 and 10. The anaesthetist Virginia Apgar introduced it in 1952; her name also serves as a memory aid: Appearance, Pulse, Grimace, Activity, Respiration.
The five signs
| Sign | 0 points | 1 point | 2 points |
|---|---|---|---|
| Skin colour | blue or pale all over | body pink, hands and feet blue | pink all over |
| Heart rate | no heartbeat | below 100 per minute | above 100 per minute |
| Reflexes | no response to stimulation | grimace | grimace with cough, sneeze or vigorous cry |
| Muscle tone | limp and floppy | some muscle tone | active movement |
| Breathing | not breathing | slow or irregular | good cry |
When it is measured
The score is recorded for every baby at 1 minute and at 5 minutes. If the 5-minute score is below 7, it is repeated every 5 minutes for up to 20 minutes. The 1-minute score shows how the baby tolerated the birth; the 5-minute score shows how well it is adapting to life outside the womb and how it responds to any help it is given.
What the total means
For the 5-minute score, the joint statement of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists uses three ranges: 7 to 10 is reassuring, 4 to 6 moderately abnormal and 0 to 3 low. A perfect 10 is unusual, because almost all newborns lose one point for blue hands and feet in the first minutes – that is normal.
Worked example
Five minutes after birth a baby has a pink body with bluish hands and feet (1), a heart rate of 140 beats per minute (2), cries when the soles of the feet are rubbed (2), moves arms and legs actively (2) and breathes regularly with a strong cry (2). Total: 1 + 2 + 2 + 2 + 2 = 9 – reassuring. A baby that is blue all over (0), has a heart rate of 90 (1), only grimaces (1), shows some flexion (1) and breathes irregularly (1) scores 4 – moderately abnormal, and the check is repeated five minutes later.
What the score cannot do
The score is a snapshot with subjective elements, and two observers can differ by a point. It is influenced by gestational age, by medication given to the mother, by malformations and by resuscitation measures; a healthy premature baby can score low simply because it is immature. A low score alone does not show that there was a lack of oxygen, and it does not predict how an individual child will develop.
Frequently asked questions
What is a normal Apgar score?
A score of 7 to 10 at five minutes is classed as reassuring. Scores of 7, 8 or 9 are normal; 10 is unusual because most newborns still have bluish hands and feet in the first minutes.
What does an Apgar score of 6 or lower mean?
At five minutes, 4 to 6 is called moderately abnormal and 0 to 3 low. The baby may need help with breathing, and the score is checked again every five minutes for up to 20 minutes. It is not a prediction for the individual child.
Why is the Apgar score taken twice?
The 1-minute score shows how the baby came through labour and birth, the 5-minute score how it is adjusting afterwards. The change between the two shows how the baby responds to any support.
Does a low Apgar score mean my child will have health problems?
No. A lower score does not mean that a child will have serious or long-term health problems. The score was not designed to predict long-term health; it describes the baby’s condition at that moment and how the baby responds to help – it does not decide whether help is given.
Who assigns the Apgar score?
The midwife, nurse or doctor present at the birth assesses the five signs. Parents can ask the team for the two results, the score at one minute and the score at five minutes.
What does APGAR stand for?
The score is named after Dr Virginia Apgar. The letters are also used as a memory aid for the five signs: Appearance, Pulse, Grimace, Activity and Respiration.
Sources and legal basis
- ACOG Committee Opinion 644: American College of Obstetricians and Gynecologists, Committee on Obstetric Practice; American Academy of Pediatrics, Committee on Fetus and Newborn: The Apgar Score. Committee Opinion No. 644. Obstet Gynecol 2015;126:e52–5 (five criteria, 0–2 each; 5-minute score 7–10 reassuring, 4–6 moderately abnormal, 0–3 low; below 7 repeat every 5 minutes up to 20 minutes; “Reaffirmed 2025”, accessed 5 Oct 2026)
- MedlinePlus (U.S. National Library of Medicine): Apgar score (description of the points 0, 1, 2 for each criterion; review 20 Oct 2024)
As of: · Editorial policy
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