Prenatal care and perinatal planning are paramount for successful delivery outcomes in human pregnancies and has been shown to be equally as important with non-human primates. The authors describe two pregnancies and deliveries of a 12-year-old primigravid western lowland gorilla, Macy. Macy’s first pregnancy resulted in a stillbirth and was complicated by breech positioning, while her second pregnancy resulted in a viable infant. This case report outlines the prenatal care Macy received in her pregnancies and highlights the importance of ultrasound for dating and fetal evaluation. The authors discuss options for breech positioning and considerations for cesarean section. This article showcases how obstetricians and veterinarians can implement human obstetrical recommendations with non-human primates to improve delivery outcomes.