Introduction:When the woman is in labor, childbirth and puerperium, they need to be accompanied by a medical team and a reliable companion. In this context, the occupational therapist promotes actions to occupational performance. Objective: To describe the possibilities of occupational therapist's interventions in a high-risk obstetric center. Method: A descriptive, documentary, retrospective, quantitative study carried out in a multiprofessional integrated residency health program at a reference hospital in Recife-PE, from April to June 2018. Sample composed of records of 10 occupational therapists residents from 2010 to 2017. The analysis was performed using Microsoft Excel, SPSS and Chisquared test. Results: A total of 351 records and 45 reports were evaluated, it was possible to observe more frequency of the interventions by R1 in labor and puerperium. While, among R2, the prevalence was in prenatal and other gynecological/obstetric situations. The interventions found in prenatal care were: activities of daily life -ADL (29.1%), psychosocial approach (27.4%) and health education (21.2%). In the labor were: assistance in labor and childbirth (71.8%), health education (11.3%) and psychosocial approach (10.3%). In puerperium were the ADL (43.1%), psychosocial approach (14.5%) and instrumental activity of daily living (12.4%). The occupational therapist elaborates actions to favor the functional and occupational performance of the woman, encompassing the different dimensions of the pregnancy-puerperal period in the hospital context. Conclusion: The practice of the occupational therapist in the HOC promotes paradigm changes, making the woman protagonist in their performance areas and favoring actions of health promotion.