Cultural context is important to understanding cross-cultural difference in adjustment to pregnancy and the postpartum period. Culture is complex, with interrelated variables posing challenges for research. Highlighted with examples of research with women from Western, Eastern, Native, and Other cultures, the chapter discusses variables such as acculturation and acculturative stress, social support, religious and spiritual beliefs and practices, and help-seeking and utilization of services in perinatal mental health and adjustment. Although rates of psychiatric symptoms and disorders vary across cultures, postpartum depression is universal and most often reflected in the perinatal mental health literature. Research on interventions and services mainly examine Western approaches as standard models of health care; however, understanding cultural context can help to inform directions for intervention adaptations or tailoring through a “cultural lens.” There are growing segments of cross-cultural perinatal mental health research, but many gaps still remain.