This chapter explores how childbirth can contribute to the onset or exacerbation of psychiatric disorder, and discusses the relative contributions of aetiological factors, including biological, environmental and psychosocial factors. Women with mental health problems, unless supports are in place, will have difficulties in caring for their babies. These difficulties may result directly from the mother's illness, from secondary mother-child separations owing to early and recurrent hospitalizations, or from marital problems. Psychiatric disorders associated with childbirth are traditionally divided into three categories, reflecting severity: maternity blues, postnatal depression (PND) and postpartum psychosis. A survey of services for mentally ill mothers and their infants in the UK concluded that there were 'few comprehensive services with specialist knowledge of the impact of mental illness on the baby and older siblings, as well as on the infant's father'. The chapter presents a case example, which illustrates a number of aspects of a perinatal service.