Dr. Virginia Apgar: The Woman Who Changed How the World Welcomes Life

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Dr. Virginia Apgar (1909–1974) was an American physician whose work transformed neonatal medicine and dramatically improved newborn survival worldwide. Best known as the creator of the Apgar Score, she introduced the first standardised, rapid method for assessing the health of newborn babies immediately after birth — an innovation now used universally in delivery rooms across the globe.

Early Life and Education

Virginia Apgar was born on June 7, 1909, in Westfield, New Jersey. She earned her undergraduate degree from Mount Holyoke College in 1929 before enrolling at Columbia University’s College of Physicians and Surgeons, where she graduated with a medical degree in 1933 (Encyclopaedia Britannica, 2024).

Initially aspiring to become a surgeon, Apgar was discouraged by mentors who warned her that surgery would be a difficult path for a woman at the time. She instead turned to anaesthesiology — then an underdeveloped specialty — and became one of its early pioneers (National Library of Medicine, 2019).

The Birth of the Apgar Score

In 1952, while working as an anaesthesiologist at Columbia-Presbyterian Medical Center, Apgar developed what would become her most enduring contribution to medicine: the Apgar Score (Apgar, 1953).

At the time, infant mortality — particularly in the first minutes after birth — was high, and there was no consistent method for evaluating a newborn’s condition or the effectiveness of obstetric and anaesthetic practices.

Apgar proposed a simple, objective scoring system based on five observable criteria:

• Appearance (skin colour)

• Pulse (heart rate)

• Grimace (reflex irritability)

• Activity (muscle tone)

• Respiration
  

Each category is scored from 0 to 2, producing a total score between 0 and 10, assessed at one and five minutes after birth (Apgar, 1953).

The elegance of the Apgar Score lay in its simplicity: it required no equipment, could be performed by any trained clinician, and provided immediate, actionable insight into whether a baby required urgent intervention.

Transforming Newborn Survival

The introduction of the Apgar Score revolutionised neonatal care. It enabled clinicians to:

• Rapidly identify distressed newborns

• Evaluate the impact of labour, delivery methods, and anaesthesia

• Standardise newborn assessment across hospitals

• Drive improvements in resuscitation and neonatal intensive care
  

Research has consistently shown that low Apgar scores correlate strongly with neonatal morbidity and mortality, making it one of the most powerful early predictors of newborn outcomes (Casey et al., 2001).

Today, the Apgar Score is administered to over 130 million babies every year worldwide, making it one of the most widely used clinical tools in medicine (World Health Organisation, 2023).

Championing Women and Public Health

Despite her monumental contribution, Apgar often faced gender-based discrimination. She was denied admission to professional societies early in her career and was rarely credited with the authority afforded to male peers (Buck, 2015).

In 1959, she earned a Master of Public Health from Johns Hopkins University and shifted her focus to broader maternal and child health policy. She later joined the March of Dimes, where she became a leading advocate for the prevention of birth defects, rubella vaccination, and maternal health education (March of Dimes, 2020).

She was also a tireless communicator — lecturing globally, publishing extensively, and translating complex medical ideas into accessible public knowledge.

Legacy

Dr. Virginia Apgar died in 1974, but her legacy is embedded in every delivery room across the world. Few medical innovations can claim such universal, lasting impact.

Her work did more than save lives — it changed the way medicine values the first moments of life, ensuring newborns were no longer invisible patients.

As Apgar herself once said:

“Nobody, but nobody, is going to stop breathing on me.”— Dr. Virginia Apgar

References

• Apgar, V. (1953). A proposal for a new method of evaluation of the newborn infant. Current Researches in Anesthesia & Analgesia, 32(4), 260–267.

• Buck, C. (2015). Virginia Apgar and the Apgar score: How one woman changed obstetrics. American Journal of Public Health, 105(3), 421–423.

• Casey, B. M., McIntire, D. D., & Leveno, K. J. (2001). The continuing value of the Apgar score for the assessment of newborn infants. New England Journal of Medicine, 344(7), 467–471.

• Encyclopaedia Britannica. (2024). Virginia Apgar. https://www.britannica.com

• National Library of Medicine. (2019). Changing the face of medicine: Virginia Apgar. https://cfmedicine.nlm.nih.gov

• World Health Organization. (2023). Standards for improving quality of maternal and newborn care. https://www.who.int

• March of Dimes. (2020). Virginia Apgar and the March of Dimes. https://www.marchofdimes.org