The decision to start or continue psychiatric medications during pregnancy requires careful consideration of the risks for both the mother and her fetus and should be guided by available safety data, as well as the psychiatric history of the mother. For many women with severe mental illness (SMI), pharmacologic treatment during pregnancy will be necessary. During this session, Dr. Smith will review general clinical approaches to psychiatric medication use during pregnancy, with an emphasis on medication use in the SMI population. She will examine current safety data for antidepressants, mood stabilizers and second-generation antipsychotics and review reliable reproductive safety resources. Lastly, she will discuss the expected physiologic changes in pregnancy that can impact psychiatric medication pharmacokinetics and clinical examples around management of these changes.