Virginia Apgar: An Advocate for Newborn Health
The APGAR test, a standard newborn test developed in 1953 by Virginia Apgar, assesses an infant's health immediately after birth. At 1 and 5 minutes post birth, the infant is examined and given a score based on the following criteria: heart rate, respiration, color, muscle tone, and reflex irritability. The term APGAR score is a mnemonic learning aid based on its inventor’s last name which stands for Appearance, Pulse, Grimace, Activity and Respiration. By the 1960’s, because of its readability and effectiveness, this score was used widely across the United States. Now, it is globally used and adopted by most doctors and midwives.
This pioneering anesthesiologist worked effortlessly throughout her career to save countless newborns. Born in New Jersey in 1909, she became passionate about medicine in High School. She completed an undergraduate degree at Mount Holyoke College in zoology with minors in physiology and chemistry. She also played on multiple sports teams, reported for the college newspaper, acted in local plays, and played violin in the orchestra. Her teachers were astounded at her capacity to succeed.
She went on to attend Columbia University College of Physicians and Surgeons (CUCPS) as one of nine women in a class of ninety. She received her medical degree in 1933 and began a surgical residency. The chairman of surgery at CUCPS highly encouraged Apgar to switch to anesthesiology. Anesthesiology, at the time, was given by nurses but surgeries became more and more complicated. This procedure then became a doctor’s specialty. Because the field was relatively new and unresearched, Apgar had the enthusiasm and grit to take it and run with it. And that is just what she did. In 1937, she received her anesthesiologist’s certificate and returned to CUCPS to become the director of the newly formed division of anesthesia and, in 1949, she became the first female full professor in CUCPS’ history.
This high position allowed her to research and study more in depth at Sloane Hospital for Women with laboring and new mothers. She soon realized that there was no developed way and standardized measure to asses the overall health of newborn babies. Mortality for children under a year old in the U.S. had been going down in this time, however, the rate of mortality for newborns remained the same. This was mostly due to the fact that doctors weren’t identifying the babies that were born at risk. Hence no necessary interventions could be put into play. This prompted the brilliant Virginia Apgar to develop the APGAR score in the 1950’s.
She went on, in 1959, to pursue a Masters of Public Health degree at Johns Hopkins University and soon after took a position at the March of Dimes Foundation directing its research into the prevention and treatment of birth defects. She was one of the first people to focus on the effects that premature birth has on an infant’s overall health. Today, the March of Dimes still works to prevent premature birth and is one of their top priorities because of the legacy Apgar left them with. Apgar published over 60 papers and continued to tirelessly work and research until her death in 1974.
David Rose wrote, on the 100th anniversary of her birth in 2009, “Virginia Apgar was an irrepressible and charismatic champion for babies whose wit and lively personality captivated everyone she encountered in her constant quest for improvements to maternal and infant health… it has been said that every baby is first seen through the eyes of Virginia Apgar.”