Shawn Johnson is an inspiration. She struggled at birth, overcame obstacles, grew strong and went on to become an Olympic gold medalist. Few of us can do this, but the March of Dimes wants every baby to be born healthy enough to grow up and reach for their dreams.
The Apgar Score is well-known, even to those with only passing familiarity of hospital delivery rooms and birthing centers. Yet to summarize Virginia Apgar’s entire career in the scoring system that measures a baby’s heart rate, respiration, muscle tone, reflexes, and color is much like trying to scale Mount Everest from one’s backyard. True, the Apgar Score is a standard clinical procedure that protects the lives of babies, but how does it fit in with Dr. Apgar’s other achievements?
Virginia Apgar, MD (1909-1974) was an obstetrical anesthesiologist who joined the March of Dimes to expand her outreach as an advocate for mothers and babies. She became a pivotal figure in helping to redirect our mission to birth defects prevention in the 1960s. In fact, she was the first medical leader at the March of Dimes to recognize prematurity as a serious problem that demanded a strengthened focus on the importance of early prenatal care.
At a time when fetal monitors were not yet invented and babies were given scant attention after delivery, Dr. Apgar questioned how best to evaluate the newborn infant to improve health and survival rates. With years of experience observing the effects of anesthesia on mother and child, she created a simple five-point scoring method designed to focus attention on the newborn to check its vital signs. Later, at the March of Dimes, she initiated a program for rubella immunization and insisted on making genetic history and pregnancy history a routine part of medical record-keeping on the pregnant mother. And, she always believed it a primary responsibility to remove the stigma of birth defects in her educational outreach.
In 1960, less than a year after joining the March of Dimes, Dr. Apgar participated in a prematurity prevention symposium in Pittsburgh. Thereafter, she continued to educate both the medical and lay communities about prematurity as she brought the problem to the forefront of her work to prevent birth defects. The Apgar Score, as the first clinical method to recognize the newborn as a patient, stimulated research in the prevention of birth defects, but Dr. Apgar’s larger achievement included a holistic perspective on pregnancy and infant health that did not fail to recognize the problem of premature birth. One could easily say that Virginia Apgar was the “founder” of prematurity as an essential part of the March of Dimes mission.
Virginia Apgar was an irrepressible and charismatic champion for babies whose wit and lively personality captivated everyone she encountered in her constant quest for improvements to infant health. She was a caring, enthusiastic physician with super-abundant energy, and she was always ready to explain to anyone who would listen why it is so important “to be good to your baby before it is born.”
Before your baby leaves the hospital, she gets her first checkup to make sure she is healthy. Here are some of the tests and treatments she receives.
• Apgar score - At 1 minute and 5 minutes after birth, a doctor or nurse checks you baby for five things: Heart rate; Breathing; Muscle tone; Reflexes; and Skin Color. Each gets a score of 0 to 2. The total score is called an Apgar score. If your baby has a score of 7 or more, she is in good shape! If she has a score less than 7, she probably is fine but she made need some special care.
• Vitamin K shot. Vitamin K can help your baby’s blood clot and protect her from bleeding problems. She gets this shot right after birth.
• Eye drops or ointment to help protect the eyes from infection.
• Complete physical. A health care provider checks your baby out from head to toe. He listens to her heart and lungs, feels her tummy, checks her eyes, nose, mouth, head, arms and legs. He gives her a hepatitis B shot. This is a vaccine to protect your baby from hepatitis B, a virus that can cause problems in your baby’s liver.
• Blood test – Every state and U.S. territory routinely screens newborns for certain genetic, metabolic, hormonal and functional disorders.
• Hearing test – A small microphone is put in your baby’s ear and plays soft sounds. Early identification of hearing loss in the newborn allows the baby to be fitted with hearing aids before 6 months of age, helping prevent serious speech and language problems in the future.
During her first year, your baby will see her health care provider regularly for well baby visits. This is the medical care you get for her when she’s not sick. Her checkups let the health care provider make sure she is growing and developing correctly. In the first year, your baby should get a checkup at 2 weeks, months 1, 2, 4, 6 and 9, and at 1 year.
Take your baby for these checkups even if she’s doing great and isn’t sick.
If you’re a parent or grandparent, you almost certainly heard about your newborn’s APGAR Score. But you might not know that the woman behind this acronym for evaluating a newborn’s health served as the first Medical Director of the March of Dimes, Virginia Apgar, MD. Yesterday marked what would have been Dr. Apgar’s 100th birthday. She was a leader in the field of anesthesiology and neonatology, a pioneer in medicine who completed advanced degrees in medicine and public health during a time when few women attended college. She was an accomplished world traveler, and a passionate violinist and stamp collector.
Her name is the acronym for what it measures: Appearance, Pulse, Grimace, Activity and Respiration. The APGAR is a test administered one and five minutes after birth to identify newborns who need emergency care. The strength of the APGAR Score is its simplicity. While the score has been refined over the past 60 years, it has rarely been improved. Originally scribbled on the back of a card in a hospital cafeteria in 1949, it is said that the score was developed “to force physicians and nurses to pay more attention to newborns” in the first critical moments of life.
Dr. Apgar used a simple message, with the right people at critical moments. And she profoundly improved the lives of babies.
You were pregnant for a long time. You did all you were supposed to do with diet and exercise and everything else, and then you delivered your little treasure. The first thing the medical staff did with your bouncing baby was administer the APGAR test and come up with a score. Did you know anything about it at the time? I didn’t when I had my kids.
Dr. Virginia Apgar was an anesthesiologist best known for developing the “Apgar Score,” a clinical system for evaluating the physical condition of newborns at birth. (More about this amazing woman in a future post.) Developed in 1952, this scoring method is still used around the world today.
The Apgar score is designed to check your baby’s condition at 1 minute and 5 minutes after birth. Your baby is checked for five things:
A – Activity; muscle tone
P – Pulse rate
G – Grimace; reflex (measured by placing a bulb syringe in the baby’s nose and seeing his response)
A – Appearance; skin color
R – Respiration
Each category is given a score ranging from 0-2. The numbers are then added up for a final score. Babies who receive an Apgar score of 7 or more probably have come through delivery with flying colors and are in good condition. A score of less than 7 quickly indicates whether the newborn needs special observation or, perhaps, medical attention to address or prevent a serious problem. It is an accurate and very helpful tool for medical personnel.
