Maternal mortality rate in Japan decreased dramatically in the last 50 years. It reached 3.2, one of the lowest in the world. Currently the main causes of maternal death in Japan are hemorrhage, obstetric embolism and pregnancy induced hypertension. Several modifications to standard cardiopulmonary resuscitation are needed for pregnant women. Uterine displacement, deeper chest compressions, and early tracheal intubation are essential. Emergency cesarean delivery should be considered as soon as a pregnant woman develops cardiac arrest.