Pregnancy can be a time of uncertainty for many would-be parents. For those mothers with a pre-existing gastrointestinal (GI) disorder, it can cause many uncertainties and concerns, particuarly relating to medication and the effect of the disease on the unborn baby. This is the first in a four-article series focusing on the management of GI conditions in relation to fertility, the preconception period, during pregnancy, and the postnatal period including breast feeding. For nurses and midwives to protect and promote health and wellbeing, it is vital for them to have good insight into GI function in order to recognise abnormalities when they occur, both as part of the expected physiological adaptation of pregnancy and when intervention is required. Having this insight will allow the GI nurse to safely plan and implement evidence-based and holistic support to those who want to conceive, pregnant women, and their families as part of the wider multidisciplinary team. This article explores the various GI problems caused by pregnancy. Physiological and hormonal changes and GI problems experienced in pregnancy Veronica Hall, Consultant Nurse Gastroenterology, Catherine Owens, Consultant Midwife, Rebecca Blackwell, Liver Nurse Specialist, Royal Bolton Hospital, Bolton, England Veronica.Hall@boltonft.nhs.uk Pregnancy Gastrointestinal tract HELLP Hypremisis gravidarum Intrahepatic cholestasis of pregnancy This article has been subject to double-blind peer review Key