Perinatal mental health disorders (PMHDs) include perinatal depression, anxiety, posttraumatic stress disorder, obsessive-compulsive disorder, bipolar disorder, or postpartum psychosis. U.S. rural communities often lack access to perinatal and mental health care; taken together, this health issue of PMHDs in the rural United States is complex. As polydisciplinary scholars of rhetoric of health & medicine (RHM), health communication, and public health, we explore: how do rural U.S. communities navigate the public health crisis of PMHDs? To answer that question, we contextualize PMHDs within mental health rhetoric research (MHRR). We review literature about narrative and social support as tools for communicating about PMHDs in rural U.S. communities. We suggest future research directions for better understanding communication about PMHDs in the rural U.S.