This review intends to determine the extent to which a serious mental illness (SMI) interferes with reproductive health (RH). The primary focus is the question of whether or not, women with SMI are at high risk for sexually transmitted infections, female cancer, unwanted pregnancies, and sexual dysfunction. Eighty-four original studies published 1971–2008 are identified through database, journal and Internet searches (PUBMED, ACOG, OMNI), and categorized by their focus and sampling techniques. RH related outcomes and their determinants (awareness, stigma, others) are considered as measurable outcomes. Women with SMI have more lifetime sex partners, low contraceptive usage, higher rates of unwanted pregnancies, and are at high risk for sexually transmitted infections. The review reveals a scant data about the awareness (knowledge, attitudes) in RH among women with SMI. The findings highlight the importance of integration of the RH education into the psychosocial rehabilitation programs.