A 30-year-old gravida 1 presents for her obstetric intake visit at 8 weeks’ gestation. This patient has a body mass index (BMI) of 36. How will her prenatal care be different from that of a normal-weight patient (BMI 18.5 to 24.9)? Nearly two thirds of reproductive-aged women in the United States are currently overweight or obese. While women who are overweight may be aware of their increased baseline risk of developing cardiovascular disease, diabetes, and other comorbidities, they may not realize that they are also at increased risk of developing complications during pregnancy. To help minimize complications and risks, clinicians should remember the adage "Every visit for a reproductive-aged woman should be considered a preconception visit."