You passed your first tests at one and at five minutes old. For over seventy years newborn babies are given the APGAR test as part of an evaluation of their health. The 1-minute score determines how well the baby tolerated the birthing process while the 5-minute score tells the health care provider how well the baby is doing outside the mother. It also helps measure how well the baby responds if resuscitation is needed right after birth.
What is the APGAR? Also known as the American Pediatric Gross Assessment Record, an acronym coined as a mnemonic learning aid explains the components: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. Delivery attendants check the baby for each element and assigns points of zero and one, they then add the two scores to help determine the child’s needs. A score of 7 and above is normal, a score below three may indicate a baby needs medical intervention.
The APGAR was actually developed by an Apgar, obstetric anesthesiologist Dr Virginia Apgar.
Born in Westfield, New Jersey, Apgar was an excellent student who always wanted to study medicine.
and graduated with a degree in zoology in 1929 from Mount Holyoke College. As well as her studies, she played on seven sports teams, acted in plays, wrote for the newspaper and played violin in the orchestra.
Apgar attended Mount Holyoke College, where she not only excelled academically, she played on seven sports teams, acted in school productions, wrote for the student newspaper and played violin and cello in the college orchestra. She wrote to her parents, “I’m very well and happy but I haven’t one minute even to breathe.” Apgar graduated with a major in zoology and minors in physiology and chemistry in 1929. https://alumnae.mtholyoke.edu/blog/the-life-and-legacy-of-virginia-apgar-29/
She pursued her dream of medicine, enrolling at Columbia University’s College of Physicians and Surgeons (CUCPS). She graduated fourth in her class of ninety and one of only ten female students in 1933.
She completed her residency in surgery at CUCPS, but Dr. Allen Whipple, the department chairman, discouraged from continuing a surgical career thinking she would have a hard time finding a job as a woman surgeon. He suggested she pursue training in anesthesia, noting that any advancements in surgery would be delayed without more anesthesiology specialists.
After receiving her certification as an anesthesiologist, Apgar returned to CUCPS as director of the new Division of Anesthesia at Columbia University College of Physicians and Surgeons in 1938, the first woman to head one of the college’s specialty divisions. A decade later she became the first woman at the college to be named full professor.
As part of her Anesthesiology training she had to learn resuscitation. Apgar reportedly claimed, “Nobody, but nobody, is going to stop breathing on me.” She was known to always carry a pocket knife and rubber tubing in case someone needed an emergency airway, saving 16 lives.
At CUCPS she researched the effects of maternal anesthesia on newborns looking to lower neonatal mortality rates at birth, ‘the most hazardous time of life.’ She knew it was urgent to quickly evaluate the status of a just-born baby and to identify immediately those who need emergency care.
The Apgar Score came to her over breakfast one morning in 1949 and she jotted down the original test on a napkin. Three years of research later she would present her findings to her peers as a way to assess how well a baby has tolerated delivery. It was published in 1953, and today is still administered worldwide.
In 1959 Dr. Apgar earned a master's degree in public health from the Johns Hopkins University while on a sabbatical leave. She then devoted herself to the prevention of birth defects, becoming the director of the division of congenital defects at the National Foundation for Infantile Paralysis, now known as the March of Dimes.
The once busy college student stayed engaged and active throughout her career, she played violin and made stringed instruments, she flew planes, golfed and fished. An avid stamp collector, she would herself be honored by the US postal Service with her own stamp as part of its Great American postage series in 1994.
Dr. Apgar never married, claiming: “It’s just that I haven’t found a man who can cook.” She died in 1974 at just 65 leaving a legacy that that generations will remember her by.
