Trauma is the leading cause of maternal death in pregnancy and complicates 6–8% of pregnancies. Understanding the physiologic changes and presentation of shock in pregnancy is important and informs the distinct management of the pregnant trauma patient. The presence of a fetus adds an additional layer of complexity in the care of trauma patients. Maternal resuscitation and treatment are paramount as fetal outcome is directly related to maternal outcome. A multidisciplinary approach that includes obstetrics should be employed in the management of pregnant trauma patients.