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Attorneys Explain Low Apgar Scores at Birth

low-apgar-score-birth-injury-lawsuit Were you or your unborn baby the victim of doctor negligence that led to a birth injury? Did the obstetrician make an error when reviewing your baby's Apgar score? The personal injury attorneys at Rosenfeld Injury Lawyers handle medical negligence cases and can serve as your legal advocates.

Call our birth injury attorneys today at (888) 424-5757 (toll-free phone call) or use the contact form to schedule a free case evaluation to discuss your newborn's birth injury.

Doctors use the Apgar score to quickly assess a newborn child's health soon after birth to determine if special attention is needed. The Apgar score test is taken twice in the first few minutes, at one and five minutes, or more if there is no response to stimulation.

Low Apgar scores indicate that the child may have suffered from birth injuries and needs close monitoring and medical care. Lower scores require more intense medical intervention.

In some cases, Apgar score assessments are the direct result of the actions taken by the medical team during childbirth.

Medical Malpractice Claims for Your Baby's Apgar Score

Did your child receive a low Apgar score and is suffering from childbirth injuries with lifelong implications? Speak with a birth injury lawyer who can investigate the matter further for signs of medical negligence or malpractice.

Rosenfeld Injury Lawyers LLC is a law firm dedicated to serving our client's interests throughout Illinois and across the United States. Our team of birth injury attorneys specializes in cases that involve medical malpractice at the time of birth. Give us a phone call today to schedule a free consultation.

Since 1952, doctors have used Apgar scores to check whether a newborn required resuscitation after their mother received anesthesia during the birthing process. Before, the Apgar test was used to predict whether the newborn would survive or suffer neurological problems.

Other physicians refer to the baby's Apgar score to diagnose asphyxia immediately after birth. The first test is performed within the first minute, sometimes before newborns have had their first strong cry.

What Does the Apgar Test Measure?

The Apgar test measures the baby's condition within the first few minutes after childbirth. Within the first minute of a child's life, they are evaluated in five categories and may receive a total score as high as ten or as low as zero. A healthy child will receive a score at or near ten.

A child with a low score might need resuscitation and should be monitored for continued signs of distress. The Apgar test scores are then retaken at five minutes. At that point, if the child still has a low score, the doctors may reevaluate the newborn every five minutes.

The Apgar Scoring System

According to the American Academy of Pediatrics, the Apgar score provides a helpful shorthand for reporting a newborn infant's status and how they responded to resuscitation.

The Apgar scoring system created by anesthesiologist Virginia Apgar involves a quick test performed one minute after birth, based on an overall score of 1 to 10. The highest score refers to the newborn infant doing better in the first minute after birth. Then, a second quick test is performed five minutes after birth.

A baby's Apgar score based on five criteria ranging between seven and nine is expected, meaning that the baby is in good health. A lower score often indicates a greater risk for neonatal mortality based on one or numerous factors, including cesarean section fluid in the baby's airway due to a difficult birth.

The one-minute Apgar score refers to how well the newborn tolerated the delivery process. The Apgar score from the second test performed 5 minutes after birth reveals how well the newborn baby is thriving outside the mother's womb. In some cases, the health care provider will obtain a 10-minute Apgar score after the baby is born.

Physicians expect premature babies and newborn infants born through a cesarean section to have lower Apgar scores. Usually, a doctor, nurse, or midwife can perform Apgar testing to examine the newborn's condition involving:

  • Reflex irritability and grimace response– no reaction to active motion reflexes or airways stimulation (0), grimacing with a weak cry (1) or grimacing with a sneeze, cough, or vigorous cry (2)
  • Activity muscle tone– Muscles are limp, floppy, and loose with some bending (flexion) of the arms and legs (0), minimally active muscle tone (1), or active muscle motion (2)
  • Heart rate– No heartbeat heard to the stethoscope (0), less than 100 beats per minute (1), or higher than 100 beats per minute (2)
  • Respiratory effort– Not breathing (zero), slow or irregular breathing (1), or crying well with no respiration breathing effort (2)
  • Skin color– Pale blue skin (0), pink skin color where hands and feet remain blue (1), or the entire body is pink (2)

Testers score the Apgar test through observation with a 0, 1, or 2 to identify a birth injury, trauma, or adverse neurologic outcome during the birthing process. An average or above Apgar score usually indicates a baby who will require routine post-delivery care and not suffer any health complications.

What Does a Low Apgar Score Mean?

When a doctor observes a baby's Apgar score at three or below, the test results might indicate severe health issues requiring immediate medical intervention. The doctors perform follow-up testing for babies with low scores at five-minute intervals to determine the baby's progress in the minutes after birth.

Sometimes, increased oxygen saturation can help improve the baby's Apgar score, where the skin appears rosier as the heartbeat and respiration are normalized.

Doctors observed many babies with low scores being perfectly healthy in the first moments, minutes, hours, days when adjusting to life outside the mother's womb.

However, low Apgar scores are consistent with high newborn infant mortality rates and severe childbirth injuries such as developmental or neurological problems, brain injury, and cerebral palsy. Thus, while many doctors refer to the Apgar test to analyze the newborn's condition, it is not a predictor or indicator of the newborn's future health.

American Academy of Pediatrics: Apgar Score

Data from the American Academy of Pediatrics reveals that a newborn baby with low Apgar scores after numerous treatments usually requires immediate medical attention at a special-care nursery. After the one-minute Apgar test, medical professionals will perform a second test five minutes later on babies with a low Apgar score whose arms and legs are blue or when the baby is not breathing.

Some babies with a low Apgar score may require oxygen after clearing out the airway to assist breathing.

Physical stimulation can also help to ensure that the baby's heart rate is healthy. Most babies with a lower Apgar score will not necessarily need immediate medical care or develop severe, long-term problems that compromise the baby's health.

American College of Obstetricians and Gynecologists Apgar Score Statement

A statement released by the American College of Obstetricians and Gynecologists (ACOG) reminds doctors, nurses, and other healthcare providers to keep a baby's Apgar test scores in perspective. The statement about the baby's score stated that "the Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia. Many other factors, including nonreassuring fetal heart rate-monitoring patterns and abnormalities… need to be considered in diagnosing an intrapartum hypoxic-ischemic event."

The released statement recognizes that an Apgar score, developed by Virginia Apgar, "does not predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose." The organization works to encourage healthcare professionals to consider other trustworthy health information when interpreting Apgar scores.

Does a Low Apgar Score Mean the Birth Injury was Caused by Medical Malpractice?

Did your baby have a low Apgar score? If so, you want answers about the treatment given throughout your pregnancy and delivery by medical staff and whether everything possible was done to prevent birth injuries.

A birth injury lawyer can review your medical records to determine if an act of negligence or malpractice contributed to your child's injuries or condition. We review the vital information about your baby in their medical records that might explain what happened and see if the doctor upheld the professional standard of healthcare that led to an unhealthy outcome.

No parent should endure the emotional and financial burden of raising a child with severe developmental or neurological disorders. You must have someone working on your behalf who can review the Apgar tests, analyze the doctor's assessment, determine if there is medical malpractice, and secure the maximum compensation you will need to provide for your baby's care.

When Should I Talk to an Attorney About a Low Apgar Test Score?

Rosenfeld Injury Lawyers LLC's team will work as your legal advocates and collect and examine your medical records to determine whether your doctor deviated from the standard of healthcare. In addition, we will discuss your legal options about filing a medical malpractice claim to obtain financial compensation for your damages.

Our legal team provides every client a "No Win/No Fee Guarantee," meaning no payment from you is required until we have successfully collected compensation for you by winning your case at trial or negotiating a settlement.

Call our law office today at (888) 424-5757 to schedule a free initial consultation to learn more about your legal options, our legal services, and what you can expect from the process. All confidential or sensitive information you share remains private through an attorney-client relationship.


Many medical malpractice cases have already been resolved through million-dollar settlements to ensure families have sufficient financial compensation for providing all the treatment and caring their child requires.

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