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The paper describes clinical work with women who have children and are experiencing difficulties in their relationships with them. It draws on material from psychoanalysis, individual and group psychotherapy and short-term analytically-informed interventions with bonding and attachment issues in women attending a maternity hospital. The paper provides a clinical overview of the field, and while much applies to fathers the focus is on mothers, and on the early years. The term ‘mothers’ is used in the widest possible sense, and the many paths to motherhood are acknowledged e.g. adoption, IVF, surrogacy and so on. The therapeutic interventions include helping mothers feel that they are parents even if they do not raise their child or if they come for psychoanalytic help long after the ungrieved loss of fetus or child. There can be many difficulties in the path of motherhood including child sexual abuse, rape, depression, mental illness, and drug addiction. Current external difficulties range from lack of support and poverty, to being shackled in prison. While there are cultural differences worldwide in views on motherhood and mothering, it is likely that some of the ideas presented here are generally applicable.