At the close of the 1940s, while American medicine looked toward the developments of the coming decade, a female anesthesiologist became disturbed by a repeated occurrence at the Sloan Hospital for Women. Too often, that anesthesiologist had noted that the babies she had delivered had failed to demonstrate good infant health. That observant female doctor was Virginia Apgar, M.D.

Dr Apgar wanted to offer something that could allow doctors to recognize birth defects in a timelier manner. She decided that it would be good to assess infant health immediately after the birth of a child. She then created a new type of scoring system. Doctors using that system could begin to assess infant health within one minute after the child’s birth.

Doctors and nurses in delivery rooms had begun to use Dr Apgar’s scoring system some time in 1952. They used her guidelines to assess the health of each newborn infant. They then summarized the infant health with a number between 1 and 10. That number came to be called the Apgar score.

Armed with the Apgar score, obstetricians could better address questions from new mothers, questions regarding the health of their new son or daughter. Armed with the Apgar score, health professionals developed greater ability to detect possible problems at a much earlier stage of each child’s life. In that way, those problems could be tackled in a timelier manner.

Dr. Apgar had identified five different areas where signs of poor infant health could become evident to the professionals in the delivery room. Those areas have been defined as activity (muscle tone), pulse, grimace (reflex), appearance (skin color), and respiration. The first letter for each area produces the name of a leader in the campaign for infant health—apgar.

Now when health professionals in the delivery room note that an infant has no muscle activity, they know right away that something is wrong. Now if an infant has a pulse that is below 100 beats per minute, the doctors plan immediately to conduct further tests. That low pulse tells them that there could be a problem.

Now as health professionals hold a newborn infant they do more than admire it. They try to test its reflexes. A sneeze or a cough is a sign of infant health. An effort by the small child to pull away is also a good sign. A grimace from the newborn baby signals the need for more tests. The absence of a response raises a “red flag.”

Dr Apgar had noted that few infants had a normal color over their entire body. Many infants had some blue-gray coloring in the extremities. She realized that infant health did not always require a score of 10. She wanted new mothers to realize that they should not loose sleep over a score of 7 or 8.

By the same token, Dr. Apgar confirmed the long-held belief that a crying infant is a healthy infant. A crying infant has good respiration. A crying infant should put a smile on the faces of the parents.

Dr. Apgar liked to see smiling parents. Her score was largely developed as a way to answer that often-asked question: “Is my baby all right?” Dr. Apgar later wrote a book, a book that used the same question as a title.