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Objectives: First, to compare multilevel emotion processing (EP) of pregnancy between substance-abusing and non-using women, and, second, to analyse whether different types of interventions can increase positive and functional EP and decrease negative and dysfunctional EP among substance-abusing mothers. EP was conceptualised according to the multifocal theory of emotions proposed by Frijda in 1986, comprising feeling states, behavioural urges to act, cognitive appraisals, and meta-emotions. Method: Participants were 101 women, 51 with substance abuse disorder and 50 comparisons. The substance-abusing women were provided with either intensive psychodynamic mother–infant group therapy (PGT; n = 25) or individually tailored psychosocial support (PSS; n = 26). All women reported their EP once during pregnancy (T1; N = 94), and twice postpartum, when the child was four (T2; N = 84) and twelve (T3; N = 76) months. Results: As hypothesised, the results indicated that the pregnancy-related EP of substance-abusing women was characterised by more negative and fewer positive feeling states, by more intense behavioural urges to act and by lower levels of cognitive appraisals of agency and predictability than the EP of the comparison women. As far as the interventions' effects on EP, intense behavioural urges to act decreased only in the PGT group, while negative feeling states decreased and agency and predictability appraisals increased from pregnancy to postpartum in the PSS group alone. Conclusions: The importance of helping substance-abusing mothers enhance optimal emotional quality as they prepare for and enter motherhood should be emphasised. [ABSTRACT FROM AUTHOR]