OBJECTIVE Since the 1970s the number of women physicians has steadily increased and is expected to continue to climb into the next century. Psychiatry is a medical specialty that has been successful in attracting women. As more young women enter psychiatry, more colleagues will be pregnant in the workplace. This paper explores some of the practical issues that pregnancy poses for the early-career psychiatrist, her colleagues, and her patients. METHODS A MEDLINE search was conducted. Literature on the pregnant physician, the pregnant therapist, and the pregnant resident was reviewed. Recommendations found in these resources were combined with the author's observations to create a single resource paper that outlines common problems and practical strategies for the psychiatrist who is pregnant. RESULTS The integration of the psychiatrist's maternal identity with her professional identity is a task that often begins during pregnancy. The fear of abandonment is a common theme for patients under her care. Relationships with colleagues are sometimes strained. The medical workplace has been slow to accommodate the needs of women, who make up a growing percentage of professional employees. CONCLUSIONS The reproductive years and the early years of practice overlap for a growing number of women in psychiatry. The life experience of motherhood can be an important part of one's growth as a psychiatrist. Relationships with coworkers and patients can be eased if potential problems are recognized and dealt with early on. Employers and medical organizations are challenged to make an investment in women professionals through the development of family-oriented policies.