Doctors were missing signs that a baby was, for example, starved of oxygen, a factor in half of newborn deaths. Some doctors assumed that babies that were underweight or struggling to breathe should be left to die. “It was considered better not to be aggressive. You dried them, you shook them and some doctors patted them on the backside and that was it,” said Professor Alan Fleischman, professor of pediatrics at the Albert Einstein College of Medicine in New York.
There was a dire need for a system that checked vital signs, such as heartbeat and breathing rate, from the minute a baby was born. That way, the appropriate special care could be put into place before it was too late.
Virginia’s eureka moment occurred one morning while she was having breakfast in the hospital canteen. One of her medical students asked her how to evaluate newborn babies’ wellbeing. Virginia replied, “That’s easy. You would do it like this,” and jotted down the five vital signs to look for. Initially called the Newborn Screening System, it was the first version of what became the Apgar test.
The medical student may have been surprised by the seemingly instantaneous production of a new scoring system, but Virginia’s thoughts were the result of her many years of painstaking observations and clinical knowledge.