•Increasingly complex patients are presenting for obstetric care, and up to 4% of pregnant women present with cardiovascular disease. After obstetric causes, cardiovascular disease is the leading cause of peripartum mortality. (1)

•The Society for Obstetric Anesthesia and Perinatology (SOAP) developed the Enhanced Recovery After Cesarean (ERAC) protocol to provide evidence-based recommendations that optimize post-cesarean outcomes. (2)

•These guidelines may be implemented and modified to suit the specific needs of complex cardiac patients.