For a woman with bipolar disorder, decompensation during the course of pregnancy can have significant consequences for both her and the baby. Women with bipolar disorder are also at greater risk for unplanned pregnancy. Therefore, it is essential that psychiatric providers proactively discuss pregnancy plans and treatment options during pregnancy and lactation with all women of reproductive age. Mood stabilizing medications and nonpharmacologic treatment options are equally important components of treatment for bipolar disorder. A comprehensive treatment plan should include a thoughtful discussion about the risks of untreated illness, balanced alongside with the risks and benefits of treatment.