The objective of this study was to investigate changes in the levels of toxic and essential elements in maternal blood during pregnancy and subsequently. A subset of 211 pregnant women from the North Norwegian Mother-and-Child Study was included. Blood samples were collected during the 2(nd) trimester (P1) and postpartum (day 3, P2; and 6 weeks, P3) in different regions of northern Norway, and were analyzed for a suite of 10 selected elements. The latter feature three general but distinct concentration patterns across the three collection periods, namely: progressive increase [Group 1: As, Cd (non-smokers only), Mn, Pb and Zn]; V-shaped, with a minimum at P2 [Group 2: Cd (smokers), Hg, Mo and Se]; and downward V, with a maximum at P2 [Group 3: Co and Cu]. These trends are interpreted in the context of underlying metabolic, hematological and physiological changes that occur in mothers, as well the biochemistry and accumulation preferences of these elements within the whole blood compartment and breast milk. Implications for biomonitoring strategies are discussed. In a multivariable analysis of the P1 data, fish consumption was a robust positive predictor for Hg (p < 0.02), As (p < 0.01) and Se (p ≤ 0.001) blood concentrations, multivitamin intake for Se (p < 0.001), and parity for Co (p < 0.002); age reached significance only for Hg (p < 0.001). An inverse association was observed between parity and Hg (p < 0.05). For the other elements, predictor patterns were not evident.