<p>Perinatal mental health conditions (PMHCs), including depression and anxiety, are the most common complications of pregnancy and postpartum, yet they remain underrecognized and undertreated. Limited therapist training in PMHCs can compromise care and contribute to misdiagnosis, stigma, or harm. This qualitative study explored therapists’ perspectives on their readiness to address PMHCs using interpretive phenomenological analysis (IPA). Semi-structured interviews were conducted with 29 licensed therapists practicing in California. Three superordinate themes emerged. “It’s just one of those things; you just don’t know until you know”: Therapists learning that perinatal mental health is distinctive, 2) “It takes a tremendous amount of sensitivity and empathy”: Therapists navigating complex and nuanced client needs, and 3) “It’s important, and it’s undervalued”: Therapists reflect on the paradox of perinatal mental health as a specialization. Participants developed readiness through personal experience, professional exposure, and self-directed learning rather than formal training. Most reported gaps in graduate education, clinical supervision, and continuing education. Findings underscore the need for a structured workforce development pipeline that includes culturally responsive and anti-oppressive training, supervision, and policy alignment. This study contributes to the growing literature on PMHCs by centering therapists’ voices and identifying pathways to competency. Implications for clinical education, licensure standards, and interprofessional collaboration are discussed. A perinatal mental health-informed workforce is critical to ensuring ethical, equitable, and effective care for birthing people and families across diverse settings.</p>