This learning activity examines the transition from outpatient to inpatient care for high-risk pregnancies, focusing on nursing competencies essential for patient safety and optimal outcomes. Content covers common conditions requiring hospitalization, evidence-based admission criteria per ACOG guidelines, and contemporary trends including digital health integration and telehealth monitoring. The activity emphasizes practical skills such as systematic risk assessment, structured communication using SBAR, patient education, and interdisciplinary collaboration. Legal-ethical considerations including informed consent, documentation, and addressing implicit bias and health disparities are integrated to prepare nurses for providing safe, equitable care during these critical transitions.