January 24, 2019
Dr. Luella Klein, one of the heroines of American medicine, died last week at the age of 94. Dr. Klein was a lifelong advocate for women and women’s health. She understood that women are at the center of the health and healthcare of their families, thus making the health, education, and social status of women even more important for their communities—in the United States and abroad.
Dr. Klein, who was discouraged from studying medicine while an undergraduate at the University of Iowa (where she graduated summa cum laude in 1946), went on to forge an extraordinary career in obstetrics and gynecology. After graduating from medical school at the top of her class (elected to AOA), she went on to train in obstetrics and gynecology—a field with very few women at the time—and spent two years doing research in England as a Fulbright Scholar. Following several years in private practice, she joined the Emory faculty in 1967 where she made a lasting impact and remained for the rest of her career, retiring in 2013.
I first met Dr. Klein when I was a fellow in Neonatal-Perinatal Medicine at Emory University. Dr. Klein was a formidable presence for a young neonatal fellow. She was very smart, had an encyclopedic fund of knowledge, was an outstanding clinician and educator— and was very outspoken. She was tough and she never minced words. In short, she intimidated me. BUT, I learned an enormous amount from Dr. Klein—first about maternal fetal medicine and the central role of the mother to the health of the baby; but more importantly about being fearless, about standing up for what you believe and think is right, about health equity, and finally about women and leadership.
Dr. Klein started Maternal Fetal Medicine (MFM) at Emory University and Grady Hospital—and became an early leader in the field. She worked at Grady, the county hospital, because she believed that all women deserve outstanding care—including a planned and wanted pregnancy, excellent prenatal care to rival the best care in the private community, and a healthy baby. She directed Grady’s maternal and infant care project and co-directed the Emory Regional Perinatal Center (ERPC) with one of my lifelong mentors, Dr. Alfred Brann (her counterpart in Neonatology—still very productive at Emory, traveling throughout the world championing women and babies). Started in 1977, the ERPC was a novel concept—a statewide system of care for high-risk pregnant women with regionalization of perinatal care. Dr. Klein championed the use of antenatal steroids (ANS) in women with impending preterm births—to induce fetal lung maturation and reduce respiratory distress syndrome (RDS), the major killer of preterm infants—long before most in the United States believed data from the first randomized trial of antenatal betamethasone completed in New Zealand and published in 1972 (Liggins and Howie; Pediatrics 1972, 50: 515-25). Of note, it was not until an NIH Consensus Conference in 1994 reviewed the more than 20 RCTs of ANS conducted over decades that antenatal steroid use became widespread in the United States, followed by significant reduction in RDS and contributing to improved survival of very low birthweight preterm infants.
Dr. Klein was a remarkable trailblazer. She led the way for all women in medicine. She was the first woman to chair a medical school department at Emory, serving as chair of the Department of Obstetrics and Gynecology from 1986—1993. A fellow of the American College of Obstetricians and Gynecologists (ACOG), Dr. Klein was elected the first woman president of ACOG in 1984, focusing her presidency on unintended pregnancy. She later served ACOG as vice president for Women’s Health issues from 1994—2010. Dr. Klein received many honors and awards, including the Elizabeth Blackwell Award, the Family Health International Distinguished Recognition Award, the American Congress of Obstetricians and Gynecologists award for Outstanding Distinguished Service, the ACOG Lifetime Achievement Award (named in her honor, the Luella Klein Lifetime Achievement Award), and election to the Institute of Medicine of the National Academy of Science. Throughout her over 60-year career, she remained a staunch advocate for women and a leader in national and international health policy affecting women.
The attached article, “A Woman’s Voice in Medicine,” was published in the New York Times after her inauguration as the first women president of ACOG in 1984. Dr. Luella Klein was a remarkable person who had an extraordinary life and career—a role model for women in obstetrics and gynecology, maternal fetal medicine, and in medicine more broadly. What a life well lived.