We assessed the frequency of severe disorders of the mother-infant relationship in over 200 mothers referred to services in Birmingham and Christchurch, all of whom were interviewed using the Birmingham Interview for Maternal Mental Health. 10.6% had established rejection and 14.6% threatened rejection of their infants. 28.6% had various degrees of pathological anger, which was severe in 8.3%. Rejection was strongly associated with unwanted pregnancy and lack of interaction with the foetus.