The combination of poor psychosocial history, existing involvement with child protection agencies, psychiatric diagnoses and admissions, medications and substance abuse, present many issues affecting outcomes for both mother and child during the perinatal period. Our study involves extensive collaboration between many different clinical groups, and will culminate in an important best-practice resource to improve the quality of life for both present and future generations. The identification of a history of serious mental illness and a planned management strategy are therefore essential if we are to improve outcomes for mother and baby.