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We argue that as uterine venous Po<jats:sub>2<\/jats:sub> sets the upper limit for O<jats:sub>2<\/jats:sub> diffusion to the fetus, high uterine artery blood flow serves to narrow the maternal arterial-to-uterine venous Po<jats:sub>2<\/jats:sub> gradient and thereby raise uterine vein Po<jats:sub>2<\/jats:sub>. In support, we show that the reported levels for uterine artery blood flow agree with what is required to maintain normal fetal growth. Although residence at high altitudes (&gt;2,500 m) depresses fetal growth, not all populations are equally affected; Tibetans and Andeans have higher levels of uterine artery blood flow than newcomers and exhibit normal fetal growth. Estimates of uterine venous Po<jats:sub>2<\/jats:sub> from the umbilical blood-gas data available from healthy Andean pregnancies indicate that their high levels of uterine artery blood flow are consistent with their reported, normal birth weights. Unknown, however, are the effects on placental gas exchange of the lower levels of uterine artery blood flow seen in high-altitude newcomers or hypoxia-associated pregnancy complications. 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