He transformed the way obstetrical care was delivered and simultaneously touched the lives of patients and the obstetricians he mentored.

With the passing of Kenneth J. Leveno, M.D., on May 2, 2020, we lost one of the most influential and transformative leaders in obstetrics. The architect of what became known as “Parkland obstetrics,” he was passionate that quality care be delivered to all, without regard for socio-economic status.

During his 42-year career at UT Southwestern and Parkland Memorial Hospital, Dr. Leveno was responsible for a number of innovations that reduced congestion, relieved overburdened house staff, and improved patient access to care. To facilitate the latter, he built an obstetrical service that integrated prenatal, delivery, and postpartum care into a unified system. He developed a low-risk delivery unit and created a nurse midwifery service. As a result of these innovations, 97% of women delivering at Parkland have received prenatal care.

Those achievements alone would be sufficient for one lifetime. But Dr. Leveno had more to offer. An editor of the seminal textbook, Williams Obstetrics, Dr. Leveno co-authored the 19th through 25th editions. He was a physician–scientist, leader, and a mentor with a mission that was inspirational and a focus that was laser sharp. Under his leadership, the way obstetricians were trained changed, and medical students who never dreamed of a career in obstetrics became “converts.”

Why sign up for one of the busiest maternity services in the nation? The answer was at once simple and complex. Dr. Leveno never lost sight of the patient. He set a high bar for himself and for those he taught. He constantly reminded physicians that they were responsible for measuring and improving the quality of care they provided. He taught them to write and challenged them “to think critically and to think big.” Even when the burdens of the service became onerous and deliveries topped 16,000 annually, he reminded residents and fellows that each of those 16,000 women was an individual who entrusted her life to their care, and it was their responsibility to treat her with dignity and provide the best care possible.

As passionate as he was about patient care, he was equally passionate about measuring that care and analyzing outcomes to discover what worked and what didn’t. His computerization of obstetrical data facilitated quality improvement and outcomes research and led to an invitation in 1996 to join the NIH Maternal-Fetal Medicine Units Network as well as to many peer-reviewed articles. Dr. Leveno took the mission beyond Dallas to the nation. His willingness to engage in contentious debate helped shape American obstetrics.

The son of Italian immigrants, Dr. Leveno graduated from the University of Notre Dame in 1964 and Creighton University’s School of Medicine in 1968. After a stint in the Army where he decided to become an obstetrician instead of a heart surgeon, Dr. Leveno did a residency in obstetrics and gynecology at St. Joseph’s Hospital in Phoenix, Arizona. There, he had the good fortune to meet Jack Pritchard, M.D., then Chair of Obstetrics and Gynecology at UT Southwestern. After listening to Dr. Leveno’s case presentation of the maternal death of an Indian woman, Dr. Pritchard sought him out. This encounter led to an invitation for Dr. Leveno to visit Dallas and ultimately to his acceptance into the Maternal-Fetal Medicine Fellowship Program under the direction of Dr. Peggy Whalley. He joined the faculty in 1978 and in 1984 became the third Chief of Obstetrics at Parkland Memorial Hospital — a position he held until November 2006.

In his memoir, Dr. Pritchard recalled his initial encounter with Senior Resident Leveno. “Two things impressed me: (1) He was well prepared and (2) he was upset with the outcome and tried to take the blame, which was unjustified.” Those words, as much as anything else, define Kenneth Leveno. He couldn’t divorce himself from a bad outcome. He had to understand why, and how, it happened and to discover what could be done to prevent its reoccurrence. This inner passion was what drove him to measure outcomes, to question treatment protocols, and to buck popular trends when evidence proved them ineffective. It was all about doing what was right for the patient. And, this is why those who trained with him hold him in such high regard.

Kenneth Leveno is gone. But, his legacy lives on in the health delivery system he created and the hundreds of physicians he mentored.