The care of the pregnant patient of AMA is often the care of a high-risk pregnancy. Comorbidities (preexisting or pregnancy-related), combined with high maternal expectation, place these patients at greater need for intervention during pregnancy and parturition. Thirty-eight percent of these patients are treated for preexisting medical conditions and almost half have preexisting medical conditions. Gravidas of AMA are also more likely to develop pregnancy-related illness. Cesarean delivery is more common in older parturients than in women younger than 35 years. Gravidas who have preexisting conditions or who develop illness should be cared for, whenever possible, in a facility capable of managing high-risk pregnancies.