Maternal morbid obesity (defined as a Body Mass Index (BMI) >40) is becoming an increasingly frequent challenge in obstetric nursing.   Safely caring for the
morbidly obese pregnant patient requires new knowledge and skills to anticipate and prevent a myriad of maternal and fetal complications.  Equally important to care is a focus on respectful compassionate care while preventing injury to patients and staff.   Patients who are morbid or super morbidly obese during pregnancy are at significant risk for medical and obstetric complications.  Common medical issues/concerns are hypertension, diabetes, infection, wound healing or integrity issues, deep vein
thrombosis, urinary tract infections, musculoskeletal, respiratory, and cardiac abnormalities.  Anesthesia, surgery, and postoperative risks are also increased.  Morbid obesity during pregnancy has been linked to increased incidence of preeclampsia, antepartum stillbirth, cesarean delivery, instrumental delivery, shoulder dystocia, prolonged labor, hemorrhage, meconium aspiration, fetal distress, early neonatal
death, and large for gestational age infants.(Cedergren, 2004, Cesario, S., 2003). 
           In this case study, we will present an overview an emergent delivery of a multiparous patient with a BMI of 71.   Particular risk factors, complications, specific equipment and supply needs, and tips/tools for safe and compassionate care will be reviewed. In addition, the authors will share a case study where the use of a newly developed multidisciplinary case management tool was instrumental in providing seamless care for a super morbidly obese patient.  This presentation is based on program development work done to meet the unique needs of this patient population at a tertiary Perinatal Center where over 4400 babies are delivered per year.