Virginia Apgar – Inventor of the Apgar Score

“Nobody, but nobody, is going to stop breathing on me”

The APGAR score, the first assessment performed on almost every new-born baby, is a mnemonic of its inventor’s name:

Appearance,?Pulse?Grimace,?Activity,?Respiration.

This simple system, first published in 1953, by Dr Virginia Apgar was transformative in infant survival.

But who was Virginia Apgar?

Dr Apgar was the youngest of 3 siblings and was born in Westfield, New Jersey. She graduated from Columbia University College of Physicians and Surgeons in 1933, one of only 9 women in her class of 90 students. After completing a surgical residency, she decided to pursue the relatively new and increasingly complex specialty of Obstetric Anaesthesiology. In 1949 she became the first female professor in the University’s history.

Virginia was a very talented all-rounder who loved sports, writing, drama, philately, gardening, and music. She played the violin in an orchestra and represented 7 different college sports teams. In later life, she even learnt to fly an aeroplane.

Despite never marrying or having children of her own, Virginia Apgar’s life-long passion was the pursuit of better maternal and infant healthcare. As well as her tremendous invention of the Apgar Score, Virginia studied the effects of local and general anaesthetics during childbirth, how best to administer oxygen to infants, and whether lack of oxygen at birth impacted on intellectual attainment in later life. She travelled the USA raising awareness of birth defects and the necessity for funding of further research into their causes. She wrote a paper entitled “the Drug Problem of Pregnancy” in 1966, detailing how limb malformations, deformed genitalia and misshapen mouths and lips resulted from the use of common drugs in pregnancy.

Determined to do more, Virginia completed a Masters in Public Health at John Hopkins University in 1959. The importance of this field of medicine could not have been demonstrated more convincingly by the rubella pandemic of 1964/65, during which Virginia witnessed the devastating result of tens of thousands of babies being born deaf and blind. A rubella vaccine became available in 1969 and Virginia campaigned tirelessly for it to be made available universally.

Painfully aware of health inequalities, Virginia worked closely with a charity to fund prenatal care for at-risk and under-served communities and provide intensive care for premature babies. The?“March of Dimes Foundation”?continues to work to end preventable preterm birth and infant death.

This remarkable, vivacious woman taught throughout her career and never retired from being a doctor. Prior to Virginia’s death at the age of 65 years, (from cirrhosis of the liver), she received numerous awards in recognition of her invaluable contributions to healthcare.

IYASU honours great women in medicine by naming our bags after them. Virginia Apgar was clearly an irrepressible champion for maternal and infant health and an inspiration to us all.