This recorded presentation explores the complex intersection between trauma, perinatal substance use, and mental health, highlighting the systemic barriers pregnant individuals face when seeking treatment. It discusses the impact of adverse childhood experiences (ACEs) and social determinants of health on substance use and recovery, emphasizing the importance of trauma-informed care. Key topics include neonatal abstinence syndrome (NAS), perinatal mood and anxiety disorders (PMADs), the role of harm reduction, and the need for integrated, compassionate healthcare approaches. By addressing stigma, improving access to treatment, and fostering supportive patient-provider relationships, the presentation aims to promote better outcomes for both parents and infants.