For this study, 200 women and men with a major mood disorder or schizophrenia were interviewed about their sexual and reproductive behaviors. The responses of the women and men were compared with those of persons from a national health survey who were matched for age and race. Compared with women from the national survey, women with mental illness had fewer pregnancies and live births but were more likely to have had a pregnancy that did not result in a live birth. Women with mental illness had more lifetime sexual partners. The findings suggest that clinicians should pay attention to patients' sexual and reproductive health.