June 7, 1909, Virginia Apgar was born. Her name may be familiar to you, but probably not because she was a leading female anesthesiologist, surgeon, professor, as well as a gifted violinist and cellist, stringed instrument maker, golfer, fly-fisherwoman, gardener, and stamp collector. Why might you have heard of her? Because her name was probably one of the first you heard uttered the day you were born. She is the woman and physician behind the famous Apgar Newborn Scoring System.
For those of us born from the ’50s on, Virginia Apgar’s system of evaluation has been used to determine how well we were doing in the transition to the outside world. I always enjoyed the process of assigning Apgar scores to newborns when I worked in OB. It wasn’t just a reflection on how well the baby was doing, but on how well I was doing on getting those floppy purple limbs pinked up and robustly flailing about. Part of the process was really just annoying the heck out of the little tyke. They’re inside there, minding their own business, staying warm and quiet, dark and cozy. Then their world literally starts to crush in around them. They’re getting squished like all get out, pushed and pulled, tilted and mashed—OR—the emergency exit suddenly opens and a pair of giant hands reaches in and yanks out the poor unsuspecting babe. Whichever method of egress, they get handed over to someone like me, someone who won’t stop vigorously rubbing them all over the place, letting the lights glare in their eyes, talking way too loudly in a very abrasive voice that is nothing like the soothing water-filtered tones they’ve grown up with, sticking things in their mouth, flicking the bottom of their feet. Whatever it takes to get that nice enthusiastic preliminary exchange of air to make sure their lungs open wide, suck in plenty of oxygen, rev up that heart beat, and create that beautiful new birth sound of really Ticked Off Baby. In the old days, those old-school pediatricians just held the baby from the ankles (helped with drainage) and whacked the little one on the tush. Not done so much now. There are better ways. But, we do go ahead and start testing them, evaluating them, labeling them with scores to categorize how well they’re doing. It’s just the beginning of the long life of stressful testing that kids will face for the next twenty-five years. And it’s a tough scoring system. No extra credit if you do well in one area but need help in another. If you have a great heart rate, that won’t help out your purple feet any. Then you’re stuck with your scores the rest of your life, even if you do really well in postpartum and take to breastfeeding right away. No one goes back and says, “Ah, she’s a good kid. Let’s bump up that Apgar 7 at Five Minutes to a 9. Let’s not saddle her with that stigma all her life.” Nope. She’s stuck with it. Forever. Even when she goes for her master’s degree all those years later. She’ll always be a Apgar 7 at Five Minutes.
Charlie just texted me the other day to ask me what his Apgar scores were. See? Something to always be concerned about. Except I couldn’t remember his. First three babies born in one minute, then Charlie came, Baby Number Four. Well, he got his own personal birth minute, which he’s always loved because deep down he also wanted to be an only child, wondering when all those other babies were going home. As far as the Apgars, I have no idea. I don’t even remember if I knew then, if you can image. We were kind of busy that day. The room was chaotic, noisy. Bustling. About thirty people in the delivery room alone. But I should have still found out. What parent these days doesn’t ask first thing? These young progressive, informed new parents, they don’t say “Ten fingers? Ten toes?” They ask, “Apgars? What are they? Really? Do you think maybe you could go easy and give him one more on his tone? He looks really toned to me. We’re really hoping to get him into that new Montessori school. If you could just, you know, add one point here or there, we’d really appreciate it.”
Happy Birthday, Virginia Apgar.
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