This talk will describe a general approach to designing a treatment strategy for psychiatric illness during and after pregnancy.  We will go into detail regarding the literature on the safety of psychiatric medications during pregnancy and lactation as well as the literature on the risks of untreated psychiatric illness during pregnancy and lactation including risks to the pregnant woman, the pregnancy, the fetus and the newborn infant. We will focus on the literature surrounding the safety of antidepressant use during pregnancy as an example of “confounding by indication.” The talk will conclude with a discussion of the new positive allosteric modulators of the GABA-A Receptor medications that are FDA approved for treatment of postpartum depression.