With growing attention being paid to perinatal mood and anxiety disorders (PMADs) in both medical and mental health settings, there is a need for further elaboration on meaningful and impactful treatments with this population. This article outlines some of the unique stressors and psychological states that come with pregnancy and parenting a newborn and infant. The concepts and experiences discussed include: primary maternal preoccupation (Winnicott, 1956), parental ambivalence, major changes to the physical body, and reorganisation of attachment representations and current family dynamics. Clinical material from therapy sessions with patients at a specialised perinatal centre is included in the discussion of using an approach informed by attachment theory (Bowlby, 1988).