Access to kidney care is a problem in Latin America, similar to many other low- to medium-income countries. Uneven access and deep discrepancies in quality of care beset this large part of the world that encompasses North America (Mexico) and Central and South America. Access to kidney care during pregnancy can be seen as a marker of overall achievements and needs in nephrology. We suggest that this issue should be systematically considered and compared across settings when health care systems are evaluated. If this were done, pregnancy would be in the spotlight, and this would increase awareness of the problems that need to be dealt with and could guide interventions to improve kidney care in young women. This review discusses some epidemiological and clinical issues, as well as barriers to optimal care of pregnancy in patients with chronic kidney disease encountered in Mexico and other Latin American countries, contextualized with a brief overview on barriers and challenges in other continents. © 2025 Elsevier B.V., All rights reserved.