Depression and anxiety also have adverse effects on the maternal-fetal environment and on infant outcome. The depressed pregnant woman is more likely to use nicotine, illicit drugs, and alcohol, and she is less likely to attend to her prenatal care (2). Antepartum depression is associated with preeclampsia, low birth weight and gestational age, and premature birth (3–5). Adverse neurobehavioral effects include toddler developmental delay and behavioral problems (6, 7). Antepartum depression is also the strongest predictor of postpartum depression (8), which in turn can have additive adverse effects on the infant's temperament, mother-infant interaction, and later infant cognitive ability (9, 10). A recent analysis from the Centers for Disease Control and Prevention's surveillance system from 17 states over 4 years found 94 pregnancy-related suicides and 139 homicides from 2003 to 2007 (20). One-half of these violent deaths were associated with intimate partner violence and psychiatric illness, which are common in pregnancy-associated suicide (21).