This chapter presents the major mental health topics of concern in pregnant patients and offers guidelines in the management of these patients in the emergency setting. Suicidal and violent symptoms should be assessed in any patient presenting with emotional, psychological, or social stress. Unipolar disorders, such as major depression, and bipolar disorders comprise the mood disorders. They tend to have an age of onset that coincides with the peak years of childbearing. The management of depression in pregnancy depends upon the severity and course of illness, presence of depression before pregnancy, treatment before or during pregnancy, available resources, and the patient's level of support. Like the mood disorders, anxiety disorders remain problematic during pregnancy; pregnancy is not protective against these symptoms. Patients with a positive domestic violence screen should be referred for treatment. Treatment varies from formal domestic violence consultations to safe havens.