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In the surreal moments after you've given birth, your brand new baby is given a quick once-over by your practitioner, who'll tell you afterward what your baby's Apgar score is. You may have no idea what it means, only that everything's okay, or it's not.
The Apgar test evaluates a newborn's muscle tone, heart rate, reflex response, color, and breathing, or "Activity, Pulse, Grimace, Appearance, and Respiration." That must be how the test got its name, right? Nope. The Apgar test is named after its inventor, Dr. Virginia Apgar, a real anesthesiologist who developed her score in 1952 as a way to summarize a newborn's health and the effects of obstetric anesthesia on babies. (The acronym was retrofitted later.)
While serving as the director of the new Division of Anesthesia at Presbyterian Hospital and Columbia University College of Physicians and Surgeons in NYC, Apgar was distressed by the high U.S. infant mortality rates in the first 24 hours after birth. She wondered: Could these newborns be saved if they were examined closely and in a standardized fashion after birth?
A lack of oxygen played a major role in at least half of the deaths of newborns, and Apgar realized that if babies having trouble breathing were identified and given resuscitation treatment and, if needed, oxygen, promptly, many of them would be saved.
Can you find Dr. Apgar in this 1955 photo of Columbia-Presbyterian Medical Center/Presbyterian Hospital surgical alumni? I bet that you can!
But how to identify these babies? As the National Institutes of Health relates, a medical resident asked Apgar how to quickly assess an infant with a standard test. "Apgar responded, 'That's easy, you would do it like this.' Grabbing the nearest piece of paper, she jotted down five objective points to check: 1) heart rate, 2) respiration, 3) muscle tone or activity, 4) reflex response to stimulation, and 5) color. These were the standard signs monitored by anesthesiologists during surgeries."
Each of the five signs, observed one minute after birth (and now also assessed at five minutes after birth, and thereafter if needed), was rated 0, 1, or 2. A score of 10 indicated a baby on the Principal's Honor Roll of health.
In time, Apgar and her colleagues were also able to look at how newborns were affected by anesthesia during labor, and found that regional anesthetics (which numb just a part of the body) were less likely to affect a newborn's oxygen intake than general anesthetics (which knock you out). So in a way, we can thank Apgar not just for the score that determines if our baby gets lifesaving medical treatments, but for epidurals too.
Color Photo by iStock
Public domain images courtesy the U.S. National Library of Medicine
This article was originally published in September, 2016.
Opinions expressed by parent contributors are their own.