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Thursday, July 13, 2006

Robert Mehnert or
Kathleen Cravedi

Papers of Virginia Apgar Added to National Library of Medicine’s Profiles in Science Web Site

Bethesda, Maryland — The National Library of Medicine’s Profiles in Science Web site has been enriched by the addition of the papers of Virginia Apgar, M.D., creator of the widely used Apgar Score to evaluate newborns. The Library has collaborated with the Mount Holyoke College Archives and Special Collections to digitize her papers and make them widely available. This brings to 18 the number of notable scientists who have personal and professional records included in Profiles. The site is at http://www.profiles.nlm.nih.gov.

In 1949, faced with unacceptably high newborn mortality rates in her hospital’s maternity ward, Virginia Apgar (1909-1974), an anesthesiologist, set out to ensure that newborns in distress got the prompt attention they needed. Using the same signs anesthesiologists monitored during and after surgery — heart rate, respiration, reflex irritability, muscle tone, and color — she developed a simple, rapid method for assessing the medical condition of newborn babies. Quickly adopted by obstetric teams, her method (now known as the Apgar Score) reduced infant mortality and laid the foundations of neonatology.

“Dr. Apgar brought enormous intelligence and energy to everything she did. Her newborn scoring method put neonatology on a firm scientific basis, and she made substantial contributions to anesthesiology and the study of birth defects. I personally found her a memorable and inspiring teacher,” said Donald A. B. Lindberg, M.D., Director of the National Library of Medicine.

Born on June 7, 1909, in Westfield, New Jersey, Apgar attended Mount Holyoke College, and then received her M.D. from the Columbia University College of Physicians and Surgeons in 1933. Although she completed a two-year surgical internship at New York’s Presbyterian Hospital, her mentor there discouraged her from pursuing a surgical career, noting that women surgeons rarely achieved financial success. Instead he recommended that she enter anesthesiology, then a new medical specialty. Apgar subsequently trained with anesthesiology pioneer Ralph Waters at the University of Wisconsin, and in 1938 returned to Presbyterian Hospital as the director of a new Division of Anesthesia. She transformed the anesthesia service during the next decade, establishing an anesthesiology education program and replacing nurse-anesthetists with physicians.

In 1949, Apgar was appointed a full professor of anesthesiology and she stepped down as director of the Division of Anesthesia. Free of administrative duties, she continued to teach and devoted more time to research in obstetrical anesthesia. Within three years, she developed the Apgar scoring method, and started using score data from thousands of infants to assess the results of obstetric practices, types of maternal pain relief, and effects of resuscitation.

Apgar was a legendary clinical teacher, well known for her fierce dedication to patients of all ages. She kept basic resuscitation equipment with her at all times, both on and off duty, explaining, “Nobody, but nobody is going to stop breathing on me!”

During a sabbatical year in 1958–1959, Apgar earned a Master of Public Health degree at the Johns Hopkins School of Public Health. She accepted an offer from the National Foundation—March of Dimes to head its new Division of Congenital Malformations, and began a new career as the Foundation’s ambassador. She was responsible for reviewing grant applications for studies in this area, raising public and professional awareness of birth defects and the research in progress, and encouraging support for the National Foundation’s research efforts. Apgar traveled thousands of miles each year between 1960 and 1974, talking to members of NF local chapters and parent-teacher groups, speaking at professional conferences, giving interviews, appearing on television talk shows, and participating in NF fundraising events. Her efforts helped double the foundation’s annual income during her tenure. From 1965 to 1974 she also served on the clinical faculty at Cornell University School of Medicine, specializing in the study of birth defects.

The online exhibit features correspondence, published articles, photographs, lectures, and speeches from Apgar’s files. An introductory exhibit section places Apgar’s achievements in historical context.

Profiles in Science was launched September 1998 by the National Library of Medicine. The Library, the world’s largest library of the health sciences, is a component of the National Institutes of Health, U.S. Department of Health and Human Services.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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