Purpose <p>Perinatal mental health conditions (PMHCs) are common, impactful, and frequently left untreated, affecting roughly one in five individuals during pregnancy and the first year postpartum. Despite their far-reaching consequences for parents, infants, and broader social outcomes, nearly 75% of those affected do not receive adequate care. In particular, individuals living in rural or clinician-shortage areas, those with limited financial resources or inadequate insurance coverage, and racial and ethnic minority populations experience both a higher burden of PMHCs and reduced access to care. In this paper, we review existing and emerging models of care with the potential to improve access to perinatal mental health care for underserved populations, with an emphasis on their potential to address structural inequities.</p> Recent Findings <p>Models of care including integrated behavioral healthcare, collaborative care, perinatal access programs, and involvement of non-specialist providers, have demonstrated an evidence base supporting feasibility and effectiveness for improving perinatal mental health outcomes. Data to support technology-enabled models of care that do not involve human-centered engagement, including digital apps and applications of generative artificial intelligence, is currently limited.</p> Summary <p>Existing and emerging models of care offer meaningful opportunities to close treatment gaps in PMHCs. Many models directly or indirectly reduce disparities in access to care by reducing patient barriers to engagement with psychiatric care. However, ensuring their impact will require sustained attention to implementation, quality, and equity.</p>