Pregnancies in women who have previously received an organ transplant are becoming more common. This is evidenced by the growing number of case reports and published studies of pregnancy outcomes involving transplant recipients. Perinatal nurses must expand their knowledge base to provide comprehensive care to this growing population. An understanding of immunosuppressive therapy and its implications for the mother and her unborn infant is necessary in providing care. The effects of the pregnancy on the therapy and vice versa need to be understood.