Perinatal mental health service development had early beginnings in the UK, and there has been rapid expansion over the past decade. As individual nations address need in their own jurisdictions, differences in service models and priorities have emerged. Innovative opportunities for addressing maternal and infant mental health needs must be balanced against the demands brought about by societal change and the COVID-19 pandemic. With such significant change, there is a unique opportunity for services and service planners to share good practice and learn from others’ successes and challenges.