Im Jahr 2022 gab es in Deutschland gema ss Statistischem Bundesamt 739000 Geburten 1 . Bei der Mehrzahl der Entbindungen ist der Fachbereich Anasthesie sowohl im Krei ss saal als auch bei der operativen Entbindung beteiligt. Das oberste Ziel ist, eine gro ss tmogliche Patientensicherheit zu erreichen und das Wohlergehen des ungeborenen Kindes zu fordern - eine fruhzeitige Evaluation der werdenden Mutter tragt hierzu ma ss geblich bei. Abstract Patient safety and reduction of possible complications are the top priorities for anesthesiologists in everyday clinical practice. Thus, interdisciplinary early assessment and optimization of patient specific medical conditions and risk factors are crucial. In obstetrics, regional anesthesia and general anesthesia are routinely being performed. To ensure maternal and fetal safety, knowledge regarding physiological changes during pregnancy is highly important. Regional anesthesia, particularly epidural analgesia, has its main field of application in the context of natural birth in the delivery room. Spinal anesthesia, as well as epidural and combined spinal-epidural anesthesia (CSE) are widely used for caesarean section. In this context, special attention should be paid to possible bleeding disorders. The combination of risk stratification and strategies to improve the patient's preoperative medical status is capable to reduce maternal and fetal complications.