Advances in transplantation medicine present the perinatal health care provider with a unique challenge: care of the woman during pregnancy after organ transplantation. Pregnancy in liver transplant recipients is complicated by hypertension, preeclampsia, anemia, and preterm birth. Neonates born to women after liver transplant are not at increased risk for congenital anomalies. Evidence to date supports that pregnancy does not have a deleterious effect on hepatic graft function or survival if the woman has stable hepatic function before pregnancy. The article focuses on the issues involved with perinatal management of the woman who is a liver transplant recipient.