To assess contraceptive use and child-rearing outcomes, a semistructured interview was given to 92 male psychiatric outpatients and to 92 matched control subjects without major mental illness. Compared with the control subjects, the patients were significantly more likely to have given up children less than 16 years of age for others to raise. Thirty-three percent of the patients who did not want to father children reported that contraception had not been used when they last had heterosexual intercourse. The findings suggest that psychiatrists should identify and reduce male psychiatric patients' risk of fathering unwanted children.