Virginia Apgar

Virginia Apgar (June 7, 1909 – August 7, 1974) was an American physician, obstetrical anesthesiologist and medical researcher, best known as the inventor of the Apgar score, a way to quickly assess the health of a newborn child immediately after birth in order to combat infant mortality.

She graduated from Westfield High School in 1925, knowing that she wanted to be a doctor from a young age.

Apgar graduated from Mount Holyoke College in 1929, where she studied zoology with minors in physiology and chemistry.

Between the 1930s and the 1950s, the United States infant mortality rate decreased, but the number of infant deaths within the first 24 hours after birth remained constant.

Apgar noticed this trend and began to investigate methods for decreasing the infant mortality rate specifically within the first 24 hours of the infant's life.

As an obstetric anesthesiologist, Apgar was able to document trends that could distinguish healthy infants from infants in trouble.

This investigation led to a standardized scoring system used to assess a newborn's health after birth, with the result referred to as the newborn's "Apgar score".

Each newborn is given a score of 0, 1 or 2 (a score of 2 meaning the newborn is in optimal condition, 0 being in distress) in each of the following categories: heart rate, respiration, color, muscle tone and reflex irritability.

Compiled scores for each newborn can range between 0 and 10, with 10 being the best possible condition for a newborn.

The scores were to be given to a newborn one minute after birth, and additional scores could be given in five-minute increments to guide treatment if the newborn's condition did not sufficiently improve.

In 1933, she graduated fourth in her class from Columbia University College of Physicians and Surgeons (P&S) and completed a residency in surgery at P&S in 1937.

She was discouraged by Allen Whipple, the chairman of surgery at Columbia-Presbyterian Medical Center, from continuing her career as a surgeon because he had seen many women attempt to be successful surgeons and ultimately fail.

He instead encouraged her to practice anesthesiology because he felt that advancements in anesthesia were needed to further advance surgery and felt that she had the "energy and ability" to make a significant contribution.

Deciding to continue her career in anesthesiology, she trained for six months under Ralph Waters at the University of Wisconsin–Madison, where he had established the first anesthesiology department in the United States.

In a 1937 photograph of Waters and his residents, she is the only woman among Waters and fifteen other men.

She then studied for a further six months under Emery Rovenstine in New York at Bellevue Hospital.

She received a certification as an anesthesiologist in 1937, and returned to P&S in 1938 as director of the newly formed division of anesthesia.

Throughout much of the 1940s, she was an administrator, teacher, recruiter, coordinator and practicing physician.

It was often difficult to find residents for the program, as advances in the medical field had only recently elevated the practice of anesthesia to anesthesiology, a fully-fledged medical specialty.

New anesthesiologists also faced scrutiny from other physicians, specifically surgeons, who were not used to having an anesthesia-specialized MD in the operating room.

These difficulties led to issues in gaining funding and support for the division.

With America's entrance into World War II in 1941, many medical professionals enlisted in the military to help the war effort, which created a serious staffing problem for domestic hospitals, Apgar's division included.

When the war ended in 1945, interest in anesthesiology was renewed in returning physicians, and the staffing problem for Apgar's division was quickly resolved.

The specialty's growing popularity and Apgar's development of its residency program prompted P&S to establish it as an official department in 1949.

Due to her lack of research (because of her focus on clinical work), Apgar was not made the head of the department as was expected and the job was given to her colleague, Emmanuel Papper.

Apgar was given a faculty position at P&S.

In 1949, Apgar became the first woman to become a full professor at P&S, where she remained until 1959.

During this time, she also did clinical and research work at the affiliated Sloane Hospital for Women, still a division of NewYork–Presbyterian Hospital.

In 1952, she developed the 10-point Apgar score to assist physicians and nurses in assessing the status of newborns.

Given at one minute and five minutes after birth, the Apgar test measures a child's breathing, skin color, reflexes, motion, and heart rate.

A friend said, "She probably did more than any other physician to bring the problem of birth defects out of back rooms."

She was a leader in the fields of anesthesiology and teratology, and introduced obstetrical considerations to the established field of neonatology.

The youngest of three children, Apgar was born and raised in Westfield, New Jersey, the daughter of Helen May (Clarke) and Charles Emory Apgar.

Her father was a business executive and amateur astronomer whose amateur radio work exposed an espionage ring during World War I. Her older brother died early from tuberculosis, and her other brother had a chronic illness.

In 1953, she introduced the first test, called the Apgar score, to assess the health of newborn babies.

She later received a master's degree in public health at Johns Hopkins School of Hygiene and Public Health, graduating in 1959.

Apgar was the first woman to head a specialty division at Columbia-Presbyterian Medical Center (now NewYork–Presbyterian Hospital) and Columbia University College of Physicians and Surgeons.

In conjunction with Allen Whipple, she started P&S's anesthesia division.

She was placed in charge of the division's administrative duties and was also tasked with co-ordinating the staffing of the division and its work throughout the hospital.

By the 1960s, many hospitals in the United States were using the Apgar score consistently.