This chapter describes the gender differences relevant to bipolar disorder (BD), reproductive health issues for women with BD, risk factors for relapse or new onset BD during childbearing, the impact of untreated BD in pregnancy and the postpartum, and the management issues and strategies during preconception and the prenatal, perinatal and post-natal periods. There are differences in the expression of BD in males and females, with women more commonly experiencing rapid cycling, depressive episodes and possibly mixed mania. Experts recommend classifying all pregnant women with BD as "high-risk" pregnancies. The principles of drug administration during pregnancy include using the lowest possible therapeutic dose, monotherapy and using agents with the lowest potential for adverse foetal effects. Pharmacotherapy is the mainstay of treatment for BD. The acute treatment of postpartum psychosis typically involves hospital admission and anti-psychotic medication. During the childbearing era, women with BD face specific risks, particularly illness exacerbation.