Anticoagulation is necessary in a variety of cardiovascular diseases to prevent thromboembolic complications. On a chronic basis, this type of therapy carries with it frustrations and challenges to both the woman and the health care provider related to monitoring, safety, and compliance. These problems are compounded during pregnancy by specific pharmacological considerations that often require substitution of a parenteral agent. Although at first this may seem an additional burden, the clinician can recruit the mother's naturally heightened awareness of health issues, as these extend beyond herself to the well-being of her child, to achieve therapeutic success.