Objectives: The aims of this paper are to quantify the effect of an innovative perinatal mental health program, the Early Motherhood Service, to identify factors contributing to its success, and to make recommendations as to its general applicability across other rural services. Method: The study involved stakeholder evaluation, analysis of available outcome data and analysis of consumer feedback data. Results: Service functions were grouped into four key areas: increasing awareness of perinatal mental health problems; providing information and advice; providing treatment and support; and education, training and capacity building. Women accessing the service showed significant improvement in outcomes as measured by change over time in the Edinburgh Postnatal Depression Scale and the Health of the Nation Outcome Scale. Consumer feedback demonstrated that the service was highly valued. Key factors identified as contributing to the service's success were broad coverage of perinatal mental health problems; inclusion of early intervention and prevention; outreach capacity; partnership with, support for and capacity building of other health providers; a location which is accessible and non-stigmatizing; and staff comprising senior and skilled clinicians. Conclusions: The Early Motherhood Service is an innovative perinatal mental health service. It provides a useful model for the development of such services in rural communities.