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Theme: Women in Medicine
Carlotta Ceccarelli
Today we will be delving into the branch of medicine that specialises in the care of women before, during and after childbirth, the intriguing sector of Obstetrics and Gynaecology (OBGYN) [1]. We will be discussing the influential innovations and sacrifices made by two different women who have one thing in common despite their generational differences- their earned respect in the medical community up until this day. Doctors Virginia Apgar and Amanda Hess will be subject to our appreciation in this week’s feature of ‘Women in Medicine’, giving prominence to these women in our blog is of high significance to us, so we may potentially inspire others as they have done so to us.
Virginia Apgar was the very “first woman at Columbia University College of Physicians and Surgeons to be named a full professor”. Her journey to becoming a successful Obstetrics Anaesthesiologist in the 1920s was windy, she was discouraged by men in the industry due to the fact that trained women at the time often failed to construct a solid career in the speciality. Anaesthesia was regarded with contempt, Dr.Apgar had trouble finding physicians to work for her, making her the only staff member for several years [2]. However, her efforts driven by her passion for maternal anaesthetics lead her to create something pivotal in the healthcare system: the Apgar Scale. The Apgar score is a standardized measure of how well a newborn is transitioning to life outside the womb, calculated by observations almost immediately after birth.
Figure [1]
Judging by the points out of 2 from each mnemonic component, the Apgar Scale is able to report the health status of a newborn baby, providing the determination for immediate resuscitation if required. There are many efficient and additional assessments used by healthcare professionals, but the Apgar score is one of the most efficient indicators straight after birth, specifically after 1 and 5 minutes of age. The ideal score range is from 7-10 points, where 0-3 points are of a very concerning range. If the scores persist below 7 after the 5-minute mark, intervention is required and the newborn would be equipped with breathing assistance or other appropriate mediations [3]. Despite some subjective limitations to this method, Dr.Apgar has been able to demonstrate through a 12 institution study that babies with a low level of blood oxygen or highly acidic blood have low Apgar scores [4]. This provided a stepping stone to predicting neonatal survival, prompting the research of cyclohexane as an anaesthetic for labouring women [5].
Aside from female-led innovation, there has been an act of heroism by Dr Amanda Hess recently that stunned many at the Frankfort Regional Medical Centre in Kentucky. It was the instinctual response by a heavily pregnant OBGYN that saved lives during risky labour. Just as Dr Hess was preparing for induced labour for her own baby girl, she felt the strong need to layer a surgical scrub over her hospital gown and help a wailing patient in need during her complicated labour [6]. Dr Hess was not the registered OBGYN for patient Leah Halliday Johnson but had been familiar with her from a few recent appointments, yet in a heartbeat, she was readily available for the assistance of this mother in pain. Leah’s baby needed urgent medical attention, having an umbilical cord wrapped around the neck and being in distress from a particularly quick labour progress [7]. Leah recalls her experience being completely professional with the miraculous healthy birth of her daughter, despite Dr Hess being in labour herself! It is the selfless nature of doctors that set an example for any prospective professional in the healthcare field, it is the woman to woman intuition that makes Females feel empowered through agonizing conditions such as childbirth.
Conducting research into these women as an Under the Microscope theme never fails to extend our appreciation and awe for our own kind. We are grateful to have a platform to talk about revolutionary advancements made on the daily, and we hope these positive insights provide inspiration amongst life during a pandemic.
Glossary:
Obstetrics and Gynaecology: Is the medical speciality that encompasses the two subspecialties of obstetrics and gynaecology. It is commonly abbreviated as OB-GYN.
Obstetrics Anaesthesiologist: A sub-speciality of anesthesiology that provides peripartum pain relief for labour and anaesthesia for cesarean deliveries.
Physicians: A person qualified to practise medicine, especially one who specializes in the diagnosis and medical treatment as distinct from surgery.
Mnemonic: A system such as a pattern of letters, ideas, or associations which assists in remembering something.
Resuscitation: The action or process of reviving someone from unconsciousness or apparent death.
Subjective: Based on or influenced by personal feelings, tastes, or opinions.
Neonatal: Relating to newborn children (or other mammals).
Induced: Bring on (the birth of a baby) artificially, typically by the use of drugs.
Scrub: Special hygienic clothing worn by surgeons during operations.
Umbilical cord: A flexible cordlike structure containing blood vessels and attaching a human or another mammalian fetus to the placenta during gestation.
References:
National Cancer Institute. n.d. Obstetrics And Gynecology. [online] Available at: <https://www.cancer.gov/publications/dictionaries/cancer-terms/def/obstetrics-and-gynecology> [Accessed 24 September 2020].
Changing the face of medicine. 2015. Dr. Virginia Apgar. [online] Available at: <https://cfmedicine.nlm.nih.gov/physicians/biography_12.html> [Accessed 24 September 2020].
Nall, R., 2018. Apgar Score: What You Should Know. [online] Healthline Parenthood. Available at: <https://www.healthline.com/health/apgar-score#normal-apgar-score> [Accessed 24 September 2020].
YouTube. 2019. What Is Apgar Score?. [online] Available at: <https://www.youtube.com/watch?v=O1RubKDvXj4> [Accessed 24 September 2020].
Khaw, K., 2009. Supplementary Oxygen For Emergency Caesarean Section Under Regional Anaesthesia. [online] Oxford Academic. Available at: <https://academic.oup.com/bja/article/102/1/90/229146> [Accessed 25 September 2020].
Hawkins, D., 2017. Kentucky Doctor, About To Go Into Labor, Pauses To Deliver Another Woman’S Baby. [online] The Washington Post. Available at: <https://www.washingtonpost.com/news/morning-mix/wp/2017/07/31/kentucky-doctor-about-to-go-into-labor-pauses-to-deliver-another-womans-baby/> [Accessed 25 September 2020].
Rosenblatt, K., 2017. Kentucky Doctor Delivers Patient's Baby Right Before Giving Birth To Daughter. [online] US NEWS. Available at: <https://www.nbcnews.com/news/us-news/kentucky-doctor-delivers-patient-s-baby-right-giving-birth-daughter-n787486> [Accessed 25 September 2020].
Figure 1.
Birth Injury Safety. n.d. What Is An APGAR Score?. [online] Available at: <https://www.birthinjurysafety.org/birth-injuries/apgar-scoring-system.html> [Accessed 25 September 2020].