<p>Black perinatal women experience high rates of mental health disorders including depression and traumatic stress disorders, but also face significant disparities in access to mental health treatment. We conducted focus groups with 43 Black perinatal women in the Southeastern U.S. to understand barriers and facilitators that affect their access to mental health services during pregnancy and post-partum as well as recommendations to promote culturally response trauma screening and services. This study leveraged Levesque’s patient-centered access framework to inform coding and analysis. Barriers to access and corresponding recommendations were identified among all five dimensions and abilities of the patient-centered access framework. Medical mistrust was a key theme that spanned several dimensions—including the likelihood of seeking care and comfort disclosing mental health concerns to a provider. Study recommendations included the need for provider training on delivering trauma-informed, culturally responsive care, increased transparency about trauma screeners to mitigate patient mistrust, and the establishment of integrative care approaches to reduce time and cost barriers to accessing mental health supports.</p>