THE WOMAN WHO INVENTED HOW TO CHECK INFANTS HEALTH
VIRGINIA APGAR
In 1952, as an anesthesiologist at Columbia University's College of Physicians and Surgeons, she noticed that newborns were often assessed haphazardly, sometimes not at all, in the crucial first minutes of life. Doctors of the era focused their attention on the mother during delivery, treating the infant's condition as a secondary concern unless something was obviously, catastrophically wrong. Apgar, frustrated by this inattention, devised a simple scoring system of five categories, each rated zero to two, checked at one minute and five minutes after birth. Heart rate, breathing, muscle tone, reflex response, and colour. The Apgar Score, as it came to be known, gave doctors and nurses a fast, standardized way to decide whether a newborn needed immediate intervention.
The score was simple, it required no special equipment, no laboratory analysis, no advanced training to administer. A delivery room nurse could complete it in the time it took to towel off a baby. This accessibility meant it could be adopted almost anywhere, from major teaching hospitals to rural clinics, and it was. Within a decade it had become standard practice across the United States and much of the world, and it remains in near-universal use today, largely unchanged from Apgar's original design. Few medical tools in history have achieved such durability with so little revision.
Before its introduction, infant distress at birth was often missed until it became severe, by which point interventions were less effective. The Apgar Score forced a systematic, immediate evaluation of every newborn, regardless of how the birth had gone, and that habit have saved lives on a massive scale. It also gave neonatal medicine a common language. Researchers could now compare outcomes across hospitals and countries using the same metric, which helped drive improvements in delivery room practice, anesthesia protocols, and eventually the growth of neonatology as its own medical specialty.
Apgar trained as a surgeon in the 1930s but was steered toward anesthesiology, then a lower-status field, partly because her mentor doubted a woman could sustain a surgical practice in that era. She became the first woman to hold a full professorship at Columbia's medical school, and she used her position at the intersection of obstetrics and anesthesiology, watching hundreds of births, to notice the gap in newborn care that others had overlooked. Later in life she left academic medicine to work for the March of Dimes, where she became a public advocate for research into birth defects, further extending her influence beyond the delivery room. Virginia took a moment of dangerous inattention in medicine and replaced it with sixty seconds of disciplined observation, and in doing so she changed how the world receives every child born into it.
365 men who changed the world.
Kamikun John, Author 366 days of wisdom.
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