Of the 3.5 million women who give birth annually in the United States, about .5 million cases are identified as high risk resulting in $200 billion dollars in annual health care costs and risk for poor adaptation to parenthood and abuse/ neglect of the infant. There is a need for early identification of families at risk and for reliable and valid instruments to assess these families. The investigators are proposing to build on previously funded research that was focused on instrument development to assess postpartum adaptation in low risk families with first newborn and with other children. The aims of this study are to: (1) modify and establish reliability and validity of the postpartum adaptation instruments to assess high risk families; (2) identify biopsychosocial factors related to postpartum adaptation of high risk families at 10 days and at 6 and 12 weeks post delivery; (3) identify specific items predicting problem areas in postpartum adaptation in these high risk families at the three points in time; and (4) compare type of problem areas in these subjects during the postpartum period at the identified three points in time. Roy's Adaptation Model will provide the conceptual framework to assess postpartum adaptation of high risk families. A pilot study will be conducted with 60 high risk families to test the modified instruments and the data collection procedure. The modified instruments to assess the mother, infant, and family will be given to a convenience sample of 240 families who meet the established inclusion criteria. Subjects will be provided instrument packets in the hospital or by mail at the identified three points in time. Cronbach's alpha will be computed to assess the internal consistency of the modified instruments and appropriate measures will be used to assess their content, concurrent, and discriminate validity. Multiple regression analytic techniques will be used to identify biopsychosocial predictors of postpartum adaptation. Univariate summary statistics will be employed to identify items predicting the instrument dimensions. ANCOVA for repeated measures will be utilized to compare the instrument dimension scores for the study groups at three points in time. Results will provide information to guide further research in the development and experimental testing of intervention packages targeted at identified biopsychosocial predictors and problem areas for low risk and high risk families as measured by the postpartum adaptation instruments.