Results indicate that infant outcomes among a particularly high risk group of mothers, those with no prenatal care, maternal substance use problems, and prior out-of-home placement of the mother’s older children were the most important factors associated with infant placement; substance use problems and prior custody loss were independent predictors of placement of infants among a sample of women with varied reasons for no prenatal care. Many women with other causes for no prenatal care including denial and concealment of pregnancy retained custody of their infant. Across groups, low rates of psychiatric evaluations were observed. Mothers without prenatal care often lost custody of their infants, especially in the substance-abusing group, but also in the other groups of mothers, at higher rates than the general population. Nevertheless, the majority of mothers who denied or concealed their pregnancy for its duration went home with their infants, though many had supervision. Mothers with denial and concealment and lacking in prenatal care were likely not optimally cognitively and affectively prepared for motherhood, yet often days after delivery they took their newborn home. Women with all causes of no prenatal care were frequently referred to social work, but few were referred to psychiatry. Mothers with substance use problems were most frequently subsequently referred to child protective services (CPS). CPS practices vary nationwide in response to mothers with prenatal drug abuse. CPS should be aware of issues among mothers without prenatal care, separate from drug use problems such as mothers with denial or concealment of pregnancy. Data were collected from 211 women. Tables and references