Trauma is the leading non-obstetric cause of maternal death. Whereas maternal mortality and morbidity due to obstetrical reasons are decreasing, those related to trauma, mainly motor vehicle accidents, are increasing. Knowledge and awareness of normal physiological changes during pregnancy and the unique response to stress and trauma, is essential for all caregivers treating trauma patients. Key points for appropriate changes in various systems and their relevant application for diagnosis, treatment and resuscitation approaches are presented. Peri-mortem cesarean section, although rarely required, is discussed. Preventive measures in pregnancy, especially the use of seat belts, are emphasized.