When your baby is born, doctors assign an Apgar score: a quick, routine assessment that checks a newborn’s health within the first minutes of life. It’s a reassuring moment for many parents: a high score typically means the baby’s heart is strong, they’re breathing well, and their muscles are active. But while a normal Apgar score is often a sign of good health, it does not always mean that a birth injury has not occurred. If symptoms of a birth injury begin showing later, don’t let the Apgar score be pointed to as proof that no one is at fault.
As any experienced birth injury lawyer will tell you, some of the most serious birth injuries don’t appear immediately. Understanding what the Apgar score measures, and more importantly, what it doesn’t, is critical for protecting your child’s health and your legal rights.
What the Apgar Score Measures — and What It Misses
The Apgar test is performed one minute and five minutes after birth (and sometimes again at ten minutes if needed). Doctors use a simple scoring system, from 0 to 10, based on five key health indicators:
- Appearance (skin color)
- Pulse (heart rate)
- Grimace (reflex response)
- Activity (muscle tone)
- Respiration (breathing effort)
Each category is scored 0, 1, or 2; a total score of 7 to 10 is generally considered normal.
However, the Apgar score is not a diagnostic tool. It’s a snapshot of how a baby adapts to life outside the womb, not a comprehensive evaluation of their neurological, muscular, or organ health. It doesn’t detect internal injuries, subtle brain damage, or conditions that develop gradually.
That’s why relying solely on the Apgar score can lead to missed or delayed diagnoses.
Birth Injuries That May Not Be Apparent Right Away
Some birth injuries are apparent immediately, such as when there is visible bruising. Others, however, may remain hidden for days, weeks, or even months after delivery.
These injuries can happen even if the Apgar score appears perfectly normal:
- Brain Injuries from Oxygen Deprivation (Hypoxic-ischemic Encephalopathy, or HIE): A baby can have a healthy heart rate and breathing right after birth, but still suffer brain damage if oxygen levels were too low during delivery.
You might notice signs like poor feeding, unusual fussiness, seizures, or your baby sleeping much more than expected. Developmental delays, such as not rolling over or babbling when expected, can also be red flags of infant brain damage.
- Nerve Injuries (Such as Brachial Plexus Injuries): Damage to nerves in the shoulder or neck during delivery might not affect a baby’s immediate vital signs, but it can show up later in subtle ways.
You may see that your baby isn’t moving one arm as much during tummy time, doesn’t reach for toys equally with both hands, or doesn’t grip your finger on one side.
- Cerebral Palsy and Motor Delays: Although children with cerebral palsy often have low Apgar scores, it’s not always the case. The condition, often caused by oxygen deprivation or trauma during delivery, isn’t usually diagnosed until months or even years later.
Parents are often the first to notice that their child isn’t meeting milestones—such as sitting up, crawling, or walking—at the same pace as other children.
These conditions can affect a child’s quality of life, requiring lifelong medical care, therapy, and support, all of which may be linked back to errors made during labor or delivery.
Why Early Diagnosis Matters
Early recognition of a birth injury is important for effective treatment and intervention. For instance, therapies for hypoxic-ischemic encephalopathy (such as cooling treatment) are most effective within hours after birth.
If healthcare providers dismiss concerns simply because the Apgar score was normal, critical treatment windows can be missed, potentially worsening the child’s long-term outcome.
That’s why parents should trust their instincts. If something feels off, if your baby is unusually sleepy, not feeding well, has trouble moving a limb, or isn’t meeting developmental milestones, request further medical evaluation.
Comprehensive neurological exams, imaging studies, and specialist assessments can uncover conditions the Apgar test cannot detect.
When to Speak With a Birth Injury Lawyer
If your child is later diagnosed with a condition that may have been caused by medical negligence, you may have legal options. Hospitals and healthcare providers have a duty to monitor fetal distress, respond to complications, and act quickly to prevent injury. When they fail to do so, they can be held liable.
A birth injury lawyer can investigate what happened during labor and delivery, review medical records, and determine whether substandard care contributed to your child’s condition.
Legal action can help families secure compensation for medical bills, long-term care, physical and pediatric occupational therapy, and other costs, and it can hold negligent providers accountable to help prevent future harm.
Trust Your Instincts — Even With a Normal Score
A normal Apgar score is comforting, but it’s not the final word on your baby’s health. Serious injuries can still exist beneath the surface, and early intervention can make a difference.
If you suspect something isn’t right, advocate for your child: seek a thorough medical evaluation and contact an experienced Chicago birth injury lawyer to discuss your rights and options.
Your child’s future is too important to leave to a single test. By staying vigilant and seeking help, you can ensure they get the care and support they deserve.