Proposed by the EPA Section on Women, Gender and Mental Health.The management of childbearing mothers with mental illness is challenging, requiring the clinician to maintain maternal wellbeing during pregnancy, whilst preventing postnatal recurrences and avoiding harm to the child. The course will cover the use of antidepressants, antipsychotics, lithium, anti-epileptic drugs and sleep-inducers in pregnant and breastfeeding mothers. Recent evidence on potential teratogenic risks of these agents arising from early pregnancy exposure will be outlined as well as effects on obstetric and infant outcome following later pregnancy exposure. Adverse effects on neonatal health will be reviewed and the current knowledge on drug transfer from the mother to the infant during breastfeeding discussed. This evidence will be related to current pharmacological guidelines for childbearing women. An important consideration in the management of childbearing women is that risks to the child do not only arise from the use of psychotropic medication. There is increasing evidence that maternal mental illness by itself and associated lifestyle and social factors can alter infant outcomes. Although there are no optimal solutions, a thoughtful and informed approach to the evidence, consideration of the woman’s own history and preferences, and maximizing benefits of non-pharmacological treatment approaches can improve individual outcomes. Preconception consultations for women who have psychosis or severe mood disorders and are planning a pregnancy, are highlighted as a means of optimizing maternal and child outcomes.