This chapter describes important aspects of therapeutic work with pregnant and postpartum clients. It then discusses therapists' tears in therapy when doing this work. In the life of pregnant and postpartum women and their partners, there are many kinds of tears. Working with pregnancy and postpartum mental health, there are so many natural situations to inspire tears. Perinatal mood disorders are only one of the many reasons that crying occurs for new mothers. Although a psychotherapist who does not specialize in working with the postpartum woman or man might think that study of perinatal mental health is not relevant, remember that prevalence is at least one in seven pregnant or postpartum women and one in ten fathers. The symptoms of pregnancy and postpartum mood and anxiety disorders, childbirth-related trauma, and psychosis are easily misconstrued by providers as having a purely psychodynamic cause. The chapter concludes by offering recommendations for practice