ESHS/HSS Annual Meeting

Making Tacit Medical Knowledge Measurable: How the Apgar Score Smuggled in Sensory Expertise through the Rise of Medical Statistics

• In Event: Disability Sciencing: Measuring and Classification at Sites of Knowledge-Making

English Abstract

Professionalization in the history of obstetrics has been noted as a process of moving towards more tools and fewer women. The rise of obstetric anesthesiology as an area of serious medical research in the 1950s was no exception—to an extent. This paper demonstrates a case of post-war measurement in medicine that smuggled in, rather than replaced, the sensory knowledge of nurse anesthetists. The Apgar Score, developed as an index of overall infant wellbeing from 1949-1952, was designed by surgeon-turned-obstetrician Virginia Apgar in the US at a time when newborns were routinely left struggling and gasping for air. This neglect mirrored the situation of Anesthesiology, a nascent area of medical research which, because it was associated with nurse anesthetists who were primarily women, was not yet taken seriously as a medical discipline and struggled to garner funding, talent, and professional independence. As soon as Apgar had successful launched a new Department of Anesthesiology out of the Division she had headed, she was quickly removed from leadership and replaced by a male colleague. Yet, she made her mark on the history of neonatology by creating a score based on her training under nurse anesthetists, rendering their knowledge legible to a professional audience hungry for ways to make the still-artisan practices of obstetricians testable. This case can open up discussion on the role that measuring practices played in smuggling sensory knowledge of marginalized actors into the post-war medical methodological hegemony.

Author

• Rebecca L. Jackson, Durham University