Perinatal posttraumatic stress disorder (P-PTSD) is not commonly included in the conversation regarding mental health concerns for perinatal or postpartum women. There is both limited research in this area as well as limited recognition of P-PTSD. Because of the lack of recognition of P-PTSD, precise prevalence rates are uncertain. The need for better awareness and understanding of P-PTSD among mental health clinicians, medical providers, and interdisciplinary care teams is imperative to best support women experiencing symptoms. The study and recognition of P-PTSD is invaluable because effects of P-PTSD for a mother and her family can be deleterious. P-PTSD affects a mother's social network and interpersonal relationships, including potentially her relationship with her child. An empathic and well-informed clinician can help to mitigate these outcomes. This article seeks to educate clinicians about P-PTSD and discusses the prevalence, risk factors for, and clinical presentation of this disorder, including a consideration of cultural factors. The need for more effective and relational screening for these disorders, as well as treatment methods, are also discussed. Future research on P-PTSD is warranted across assessment, treatment, and cultural considerations. Clinical Impact StatementPregnancy and the birth of a child are commonly considered positive life events; however this is not everyone's experience. In fact, during this period, women are at an increased risk for experiencing perinatal PTSD (P-PTSD). This article is designed to introduce clinicians to considerations about working with this population.

Perinatal substance use (PSU; i.e., substance use during pregnancy and the first year postpartum) is a challenging public health concern with implications for both the mother and her child. Perinatal women with substance use disorders (SUDs) often have difficulties with parenting including displaying high levels of negative parenting behaviors (e.g., harshness and irritability) when interacting with their children and greater difficulty interpreting their children's cues. The overlap between the systems in the brain that are involved in addiction and parent–child attachment can shed light onto challenges with parenting and the formation of healthy parent–child relationships. Parenting interventions (and interventions more broadly) for perinatal women with SUDs should be informed by the interplay between addiction and attachment. We begin by reviewing the prevalence of PSU and common parenting challenges. We then provide context to these parenting challenges by reviewing current understanding of the interplay between systems implicated in addiction and parent–child attachment. Finally, we describe existing parenting interventions for perinatal women with SUDs and highlight the need for relationally focused interventions that are strengths based and person-centered. Understanding how the neurobiological process of addiction is intertwined with past and current attachment relationships should be leveraged to inform more accessible, acceptable, and effective interventions for pregnant and parenting women with SUDs. Additionally, we describe how understanding the ways in which addiction disrupts the formation of healthy parent–child attachment has foundational implications for the treatment of PSU and the training of new clinicians.