Muscle-sparing rectus abdominis muscle harvest has been advocated to p
reserve abdominal wall integrity and to reduce postoperative complicat
ions and functional loss. In previous cases of pregnancy following sin
gle and bilateral rectus muscle harvest, muscle-sparing techniques wer
e used to fortify the abdominal wall. We report a case of uncomplicate
d gestation and delivery following total bilateral rectus muscle harve
st. While abdominal wall strength is greatly affected by rectus harves
t, the fascial and tendonous components of the abdominal wall contribu
te substantial static integrity and elasticity. Careful repair of the
donor site makes complete rectus muscle harvest an option even for wom
en contemplating pregnancy.