Background: Population based studies report increasing mental ill- health levels of women in reproductive ages. The antenatal routine care program in Sweden consists of 8-10 visits with a nurse midwife. Data from these visits, delivery and postnatal care has been collected with the National Delivery Register since 1973. No variables however exist for identifying mental health. A computerized perinatal patient record system has been in use for12 years at the University Hospital in Malmö, Sweden. It consists of some 2,500 variables possible to use for follow-up studies, as well as searchable free-text. The record system is used by all clinical staff involved with the pregnant woman. Aim: To identify markers for mental ill-health in pregnancy in registry data to predict delivery outcome. Method: Patient records from six consecutive years with 22,000 pregnancies were selected. Theoretical markers of mental ill-health related words were identified and tested in a sub-sample. A free-text-search among all patient records was performed to identify the occurrence of each of the selected markers. Results: Twenty words relating to mental ill-health instruments were chosen for the free-text database search. Presence of reported words as "panic", “anxiety” and “stress” showed an increase OR for instrumental delivery, ruptured sphincter and caesarian section. The phrase "anti-depressive" seem to lower the OR for these outcomes. Conclusion: Preliminary data seems to indicate an increased risk of obstetric complications at delivery associated with some of the markers for ill-health. Further analyses could assist in developing variables for the identification of words predicting mental ill-health and increased obstetric risks. Ethical approval 350/2007. PhD-studies by faculty funding