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Abstract: With the deinstitutionalization and the evolution of antipsychotic therapeutics, the life of psychotic women has changed. If issues related to desire, questioning and sexual life are globally similar to those of general population, this sexuality is more active with multiple sexual partners, with more unwanted and unplanned pregnancies, abortion, and sexual abuses. A review of literature reveals that limited published research exists on the subjective experiences of mothers with a psychotic illness and their desire for child. Furthermore, pregnancy of mentally-ill patients raises ethical questions for professionals who look after these women because of the illness, their environment, the social conditions of life, and their isolation. The desire of pregnancy does not fully coincide with the desire of a child. Some psychotic women want to be pregnant but do not want a child. Other women cannot establish a mother–child link because the imaginary child overrides the real baby. But, on the contrary, some are very good mothers, especially in the first months of life of the baby. How must we work with this desire of pregnancy with our psychotic patients to understand and to help them, and in order to ameliorate the preventive strategies of protection for the child in case of pregnancy? [Copyright &y& Elsevier]