LMH Health delivers best-case outcome for complicated pregnancy

Kiley Luckett’s high-risk pregnancy journey started with a dream. Kiley, then 37, had just lost her mother unexpectedly. She was grieving and uncharacteristically tired. One day, in February 2024, she got a call from a childhood friend who said Kiley’s mom appeared in a dream carrying a baby in a blue blanket for Kiley.

Kiley was touched, but shrugged off the idea that she was going to be a mom. For starters, she thought she was infertile, and as a Type 1 diabetic, she knew she needed to weigh the risks of becoming pregnant. Besides, Kiley, the director of mental health for Lawrence Public Schools, and her partner, Christopher, loved their independence and weren’t planning on kids. 

In fact, at the time of the call she was in the middle of a fertility workup through Lawrence OB-GYN Specialists, simply to confirm that she could let go of using birth control. What she didn’t know was that she was actually pregnant during those initial tests — and not just newly pregnant, but in her second trimester.

It sounds surprising, but surveys from the U.S. and Europe show that 7.5% of women don’t learn they’re pregnant until 12 weeks along, and one in 300 doesn’t know for the first 20 weeks. 

In Kiley’s case, as she was preparing for her upcoming fertility appointment, it occurred to her that she hadn’t had her period in a while. She had been busy mourning her mother, working full time, teaching a class at KU and performing in a play, and she chalked up her fatigue and irregular cycle to a full life.

She laughs now, saying she figured she might be in menopause but needed to rule out pregnancy first. So she took two at-home tests (both positive), then got a “strongly positive” blood test at LMH Health, then took another home test before she let it sink in. 

“I actually thought the tests were wrong,” she said about her level of disbelief. “I got the kind that said ‘pregnant’ or ‘not pregnant’ and I thought, ‘What if the place that says “not” broke off?’” 

Kiley quickly called Lawrence OB-GYN Specialists, who switched her infertility appointment to a pregnancy confirmation visit with her new obstetrician, Dr. Leslie Underwood. Right away, Kiley felt like they were a good match. “She’s no-nonsense and has this way about her that I just trust. I’d 100% choose her again.”

Her initial visit started with an ultrasound, where instead of seeing a little speck that confirmed she was pregnant, she got a stunning look at her new baby boy, who turned out to be at 15 weeks gestation! 

While she digested the news, she and Dr. Underwood discussed that Kiley’s pregnancy was not only quite far along, but also high-risk and in need of special precautions. The risks were many, including diabetes, high blood pressure and advanced maternal age, all of which increase the danger of complications.

Pregestational diabetes, where a mother already has diabetes before conceiving, can lead to birth defects in 6% to 12% of cases, with the greatest risk in the first eight weeks of pregnancy. It can also cause high blood pressure and preeclampsia, preterm labor, and large babies requiring early delivery or cesarean birth. 

“The most challenging thing is that we are taking care of two patients at once,” says Dr. Underwood, “a patient with a very serious chronic medical condition as well as a growing human that she is doing everything in her power to grow and protect.”

Learning what she was up against, Kiley’s initial thought was that she would need to travel to Overland Park or Kansas City for her care and delivery. She was thrilled when Dr. Underwood immediately referred her to The University of Kansas Health System’s Advanced Maternal and Fetal Care clinic (MFM) at the LMH Health West Campus instead. 

Housing an advanced maternal and fetal care team within the Lawrence community is made possible by a strategic partnership between LMH Health and The University of Kansas Health System. The clinic can manage a wide range of complex perinatal issues, including multiple pregnancies, autoimmunity, hypertension, congenital heart disease and intrauterine growth restriction.

Dr. Underwood says that she sees so many high-risk pregnancies these days it’s almost more than she can count. “It’s actually quite exhausting for us OBs. We are very thankful that The University of Kansas Health System’s MFM clinic continues to support our community. Although the perception of Lawrence may be that of affluence, we have a large population that would have a difficult time traveling to Kansas City. The clinic’s presence really helps our patients.”

Kiley turned out to be fortunate in more ways than one. Although she had struggled to manage her blood sugar when she was younger, switching to an insulin pump and a continuous glucose monitor (CGM) had transformed her diabetes care in the last 10 years, giving a big lift to her health and well-being. 

Her tight blood sugar regulation paid off, silently protecting her and her baby during those first 15 weeks when she didn’t know she was pregnant. In fact, her A1c — a measure of average blood sugar levels over the past three months — turned out to be so good that Dr. Mark Oertel, her LMH Health endocrinologist, felt comfortable letting the MFM manage her diabetes care during the rest of her pregnancy. This was one more way having advanced maternal care in Lawrence removed layers of complexity and brought Kiley peace of mind. 

Dr. Underwood elaborates: “Kiley was very comfortable managing her pump and CGM settings as she had been managing her blood sugars since she was a child. But, pregnancy can really change the insulin demands. We are very thankful to have the specialists at The University of Kansas Health System to help even our seasoned diabetic patients navigate the changes that occur during pregnancy.”

Other than continued high blood pressure, Kiley and her baby weathered the remaining months without complication. Or as Dr. Underwood puts it, they experienced “anticipated” complexities, but no “unexpected” events — which was exactly the plan.

Kiley continued her frequent appointments, labs, fetal well-being ultrasounds and coordination with the specialists at the MFM clinic throughout her pregnancy, until 37 weeks, when they advised her to deliver early to help avoid preeclampsia. 

Like many moms-to-be, when Kiley checked into LMH Health the following Sunday she had a birth plan. It’s just that hers was unusually flexible: 

“Step one,” she recalls, “keep me alive. Step two, get this baby out of me. Step three, keep my baby alive.” 

Kiley was grateful that, despite her high-risk pregnancy, she could deliver at LMH under the care of her own obstetrician. Dr. Underwood met her at the hospital and started medicine to induce labor, but it took time and Kiley’s blood pressure began rising. 

It turns out the MFM team was right to be cautious. She had developed preeclampsia, a serious blood pressure condition that can lead to seizures, kidney damage and even death. Dr. Underwood started Kiley on magnesium sulfate to prevent seizures and gave her the choice of an immediate cesarean section or medicine to speed the delivery.

“I went back and forth a little bit,” Kiley says, “and then we just made the decision to do a C-section. There is no gold medal for birthing naturally!”

The team went into action and, in less than an hour, Christopher was by her side as baby Jameson took his first breath. The labor and delivery team had turned an alarming twist into a cherished memory. 

Kiley explains: “The C-section was good, but it was scary. The staff is really spectacular at LMH. I wanted Christopher there with me, but he couldn’t be there during the first part. The last time I was in a hospital it was with my mom and she passed. It was hard for me being there alone, with the spinal, but they were right there with me, holding my hand.”

As Jameson was being delivered, she suddenly worried she wasn’t going to get any pictures given that the birth had become an operation.

“But they were like ‘Give us your phone!” she said. “They took all these pictures when Christopher was first holding him and when I did cheek-to-cheek. I mean these are all medical professionals and they didn’t have to stop what they were doing to take photos.”

Soon, Kiley went to recovery while the medical team examined the baby. Following months of monitoring and precautions, Jameson was in perfect health. He showed none of the difficulties found in newborns of diabetic mothers, including no trouble breathing or maintaining his own blood sugar. 

Kiley also fared well. She remained on the magnesium drip for 24 hours as the preeclampsia resolved and was able to go home a few days later, feeling better than she anticipated. She healed so rapidly from the cesarean that she had to force herself not to drive for two weeks as advised.

“Kiley was special because she and her partner knew that they were very high risk from the beginning,” Dr. Underwood recalls. “Their only goal was a healthy baby and mom, which is what we all pray for, right? And guess what … it happened!”

The one hurdle Kiley experienced was difficulty with breastfeeding. It’s a common challenge for new mothers; however, LMH Health maintains a 90% breastfeeding initiation rate, thanks to their board certified lactation consultants and the extensive breastfeeding education of all birthing center nurses. Kiley has a special shoutout for the staffer who helped her turn things around with Jameson: “Nurse Jodi, may your pillow always be the right temperature and your coffee always hot!”

So, what is it like now that her surprise baby is at home? 

“He’s a happy, happy baby. Every day when I come home, he’s so excited to see me and I’m so happy to see him. It doesn’t matter how bad my day was. Motherhood is so cool. I had a great life before, but now I have another somebody special to share it with.”

In the end, Kiley did get a gold medal for childbirth. Christopher awarded it to her and she displays it in her office. It reminds her of how fortunate she was throughout her pregnancy and delivery — and how blessed she feels to have had “the best accident ever!” 

Kiley and Christopher don’t really think it’s an accident, though. Jameson came home from LMH Health in a onesie that said “Hand-picked by my Granny Kay in heaven.”