Pregnancy associated cancer is fortunately rare. However, cancer risk is age related, and the proportion of births to older women in the United States appears to be increasing. As a result of delayed childbearing and better detection, cancer may be increasing in the obstetric population. A review of data from the United States Inpatient Sample found that from 2000 to 2019 the proportion of deliveries with an active cancer diagnosis doubled and deliveries with a diagnosis of a history of cancer more than tripled. These trends and associations are similar to findings from other registries and population-based studies which show that pregnancy associated cancer is increasing and associated with a range of adverse obstetric outcomes including severe maternal morbidity and preterm birth. Given these trends and findings it is likely pregnancy associated cancer will continue to be of public health and clinical importance and represent an ongoing challenge given the maternal and neonatal risks and specialized, coordinated care required to optimize outcomes.