Women with sickle cell disease (SCD) constitute a high-risk pregnancy group. SCD is an autosomal recessive inherited blood disorder. The most common and severe form of SCD is sickle cell anaemia (SCA). Knowledge of SCD and its effects on pregnancy is essential for midwives who work in areas which have a high prevalence for sickle cell disorders (>1.5 pregnancies per 10 000 births). This ensures that appropriate woman-centred care is provided. The midwife has an important role in working in partnership with the multidisciplinary team to co-ordinate individualised care and surveillance in pregnancy. This paper provides an overview of care required for women with SCD in pregnancy and the midwife's role in facilitating a positive and safe experience.