After studying this article, the reader should be able to: 1. Describe the relationship of sexual history taking and counseling to the safe prescription of teratogenic drugs. 2. Define the scope of the problem of unintended pregnancy and the importance of sexual history taking and counseling. 3. Review the skills of sexual counseling and taking a sexual health history. Although the need to take a sexual history and counsel patients about conception and contraception appears in several clinical situations, the process can be uncomfortable, and some physicians may avoid it or do it incompletely. When a patient is receiving a teratogenic agent, the need for proper history taking and counseling is critical. This article reviews ways to make the process more comfortable and rewarding for both the patient and physician.