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OBJECTIVE: This study ascertained family planning decisions by women with bipolar disorder after psychiatric consultation. METHOD: The authors surveyed 116 women with DSM-IV bipolar disorder after specialized consultation about treatment options and risks regarding pregnancy. RESULTS: Of 70 respondents, 45% had been advised to avoid pregnancy by a health care professional before consultation. After consultation, 63% decided to pursue pregnancy. CONCLUSIONS: Women with bipolar disorder often encounter obstacles from health care professionals regarding pregnancy. Individualized comprehensive review of risks and benefits of treatment options during specialized preconception consultation can support thoughtful clinical planning.