This article reviews the essential aspects of the psychopharmacologic management of women with mental health problems, with particular emphasis on the role of the nurse-midwife as a primary care provider. The article also addresses the neurobiology of psychopharmacology, pharmakinetics, and the selection of pharmacologic treatments used for depression, bipolar disorders, anxiety disorders, eating disorders, and psychosis. Considerations for the timely and appropriate referral for psychiatric intervention for women with psychiatric or pharmacologic emergencies are discussed, and issues relating to pregnancy, lactation, and reproductive health are included. The importance of the nurse-midwife's role in ensuring women's access to and compliance with psychopharmacologic therapy is emphasized.