How to Examine Your Newborn Baby at Birth

Doctors and midwives usually assign an Apgar score to newborn babies one and five minutes after they are born. The Apgar score measures heart rate, respiratory effort, muscle tone, reflexes, and color of the newborn baby. Each area is scored with 0, 1, or 2 points. The total number of possible points is 10, and most healthy newborns score between 8 and 10. When you examine your baby after an unassisted birth at home, you don’t necessarily have to assign a score. The scoring system is just a way to determine quickly whether a newborn needs medical attention or not. But it’s not a bad idea to pay attention to the five areas to set your mind at rest.

Respiratory Effort

You can easily examine the respiratory effort of your baby while you’re holding him or her. In fact, this is one of the first signs you’re looking for after birth. Obviously, your baby needs to breathe. While not all newborn babies cry, a crying baby certainly indicates that he or she is breathing. But your baby may just lie there quietly without having difficulties breathing. In this case, you can observe the movement of your baby’s chest. If your baby is not breathing at all, then that is a cause for concern. You need to act fast because humans cannot survive long without oxygen. In fact, your baby should be breathing on his or her own within the first minute of being born.


When observing the color of your baby, doctors and midwives are not talking about the skin color. Rather, they want to make sure that your baby is pink. If your baby is blue or pale all over, then he or she is not getting enough oxygen. This means you’ll probably also observe poor respiratory effort. If your baby’s hands and feet are still blue, that’s still okay as long as his or her body is pink. However, it shouldn’t take long for hands and feet to turn pink as well. Your newborn would score a 2 in this area if he or she is pink all over.

Heart Rate

Your newborn baby’s heart rate should be above 100 beats per minute. You can check the heart rate by finding the pulse on your baby’s upper arm or by putting your ear next to your baby’s chest. While there’s generally nothing wrong with checking your baby’s heart rate, it’s probably not as helpful as observing your baby’s respiratory effort and color. Detecting and accurately measuring your baby’s heart rate might not be difficult, but for a new parent, it’s not the easiest thing to do, either. It also takes more time than observing your newborn for other signs and prevents you from reacting quickly when necessary.

Muscle Tone

As you’re observing your baby, you’ll notice that he or she is actively flexing his legs and arms. This is a sign of good muscle tone and just what you want to observe. If your baby is listless and not flexing his arms or legs, then there might be something wrong with him or her.


Finally, to assign an Apgar score, the doctor or midwife will look for signs of reflexes or irritability. In order to score well in this area, your baby will offer a good cry, and most babies are happy to comply here. However, that doesn’t mean that your baby has to cry at birth. But your baby will probably show some reaction to being born even if it’s just a grimace.

What’s Important

The most important thing for you to check is that your baby is breathing. You can perform a more thorough examination soon (where you’ll count all the fingers and toes etc.). Immediately after birth, the first priority is to ensure that your baby is getting enough oxygen. The best indicators for that are seeing the baby breathe (or cry) and watching his or her skin turn pink all over.