This chapter provides an overview of the myriad of challenges faced by mothers with common neurodevelopmental disorders such as ADHD and ASD, specifically during pregnancy, the postpartum period, and the early years of motherhood. In order to structure this discussion, I will describe these challenges under biological, psychological and social factors. The perinatal period brings about several internal and external changes for the mother that can worsen already-existing neurocognitive deficits and emotional instability or cause the new onset of such deficits, commonly referred to as “pregnancy brain.” For mothers with NDD, each step, each day, each task presents its own complexity depending on the age and temperament of the child, as well as available resources for supporting the mother. Without appropriate diagnosis and treatment for NDD, as well as help with childcare, these mothers may struggle greatly to adjust to this major life transition. In highly demanding settings with limited support, they may develop clinically significant levels of anxiety and depression as well. Maternal distress can also impede critical processes such as the development of mentalizing abilities and attachment security for the offspring, which in turn has long-lasting consequences for the child’s social and emotional development.