Coagulation disorders cause significant morbidity and mortality during pregnancy, and evaluation of hypercoagulability or bleeding are frequently encountered in females of reproductive age. The physiologic changes of the hemostatic system during pregnancy increase the risk of venous thromboembolism and also make laboratory test result interpretation challenging. The risk of thrombosis can be reduced with anticoagulation, but appropriate risk stratification to assure that the benefits outweigh the risks is required. Only patients with severe bleeding disorders typically need preventive management antepartum: however, delivery planning, which has both maternal and fetal implications, is complex and requires coordination between multiple providers.