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A High-Risk Pregnancy Lifeline


Tracy Carter’s phone is a lifeline for scores of women experiencing some of the most difficult and vulnerable chapters of their lives.

As the nurse coordinator for the High-Risk Perinatal Program at Cedars-Sinai, Carter connects women with complex pregnancies with expert care from specialists. She also arranges imaging tests and screenings and efficiently navigates the complicated web of providers to make sure her patients get the care they need, when they need it. She answers the questions her patients are afraid to ask their doctors, listens to their concerns and often meets them when it’s time for them to deliver their babies.

“Everyone should have someone advocating for them, especially moms with a high-risk pregnancy,” said Carter, who is a registered nurse. “They have my number for a reason. I’m looking out for them, and it’s not just me. Until they get here, they can’t really comprehend how many people are looking out for them.”

For more than a decade, the High-Risk Perinatal Program has been serving women who need multidisciplinary care during pregnancy. Some are women who have complex health histories, such as those who have had organ transplants, heart defects or cancers. In other cases, they’re moms who encounter a complication due to their pregnancy or whose developing fetus requires specialized care.

Every week, the program convenes a team of specialists that includes maternal-fetal medicine specialists, neonatologists, pediatric and congenital cardiologists, and anesthesiologists, among others. The team considers each case and creates a detailed care plan with interventions and providers who need to be present in the delivery room. They collaborate with the women’s general OB-GYNS, as well.

“It’s extremely beneficial to have these experts come together to optimize care for these complex cases,” said Kurlen Payton, MD, director of the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s and co-director of the High-Risk Perinatal Program with Sarah Kilpatrick, MD, PhD, chair of the Department of Obstetrics and Gynecology.

“We work with families to make these really challenging decisions, sometimes in very time-sensitive situations,” said Payton.

Carter is often the face and the voice patients come to know best.

“Patients love Tracy,” said Kilpatrick, who holds the Helping Hand of Los Angeles Chair in Obstetrics and Gynecology at Cedars-Sinai. “She’s their person. She’s accessible, and she meets with them and sees them in Labor and Delivery.”

Carter has been an OB-GYN nurse for 35 years and has spent most of her career at large centers, where she has seen patients from diverse backgrounds and life experiences. She gained management experience after moving from Ohio to California seven years ago, but she missed working directly with patients. In fact, she left a management job to work with the High-Risk Perinatal Program about four years ago.

“I’m too patient-focused to be in an office for long,” she said. “I am excited to be working with patients who need this kind of care.”


Carter also connects the team to doctors and care providers throughout the region, arranging for  maternal-fetal medicine experts and neonatologists to provide consultations or to host free in-person or virtual talks. The program has a 24-hour number referring physicians can call to place patients or receive a consult on a complex case.

“We want our program to be accessible throughout Los Angeles County and beyond,” Kilpatrick said.

Carter works to make sure the care plan created by the specialists is seamlessly followed. That can include coordinating with multiple specialists and working with imaging schedulers to help women get the tests they need quickly. She also provides patients with an introduction to the program and what it offers.

“The bottom line is that once they know how our weekly meetings work as well as how many specialists and subspecialists are invested in their care, they get peace of mind,” Carter said.

“For our patients, knowing that right now all they have to do is keep themselves safe and be pregnant is a big deal,” she continued. “Managing their appointments, making sure they receive all the help and care they need—we’ve taken care of that. And I think that means everything.”