Obesity has reached epidemic proportions world-wide, including among women of childbearing age. Obesity poses risks to both mothers and babies. In this presentation, we will review factors that contribute to obesity, risks and challenges encountered in care of the pregnant obese patient, and strategies to optimize maternal and neonatal outcomes. Dr Fox is Clinical Director in the Placenta Accreta Spectrum Care Team at the Baylor College of Medicine (Texas Children’s Hospital Pavilion for Women). Her particular clinical interests include caring for women with morbidly adherent placenta (placenta accreta, increta and percreta) and pregestational diabetes.