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This study examined how frontline maternal health professionals (MHPs) perceive extreme heat risk to pregnant women and fetuses. Semi-structured interviews were conducted with a 12-participant sample of MHPs (midwives, doulas, and lactation professionals) who are health care providers and educators for the population of interest (pregnant women along the U.S.–Mexico border) in El Paso, Texas. Qualitative analysis was used to discover how participants perceived their clients’ risk of heat exposure and their knowledge concerning the health impacts of maternal heat exposure. Participants prioritized other health concerns over heat exposure; they were familiar with heat illness symptoms but were largely unaware that pregnant women and fetuses were at particular risk; they understood standard heat protective measures; and, once informed about heat risks, they requested more information about heat exposure. Gaps in MHPs’ heat risk knowledge leave pregnant women and developing fetuses at risk of preventable harm.