Positive outcomes associated with traumatic stress have been gaining attention over the past 20 years. Posttraumatic growth (PTG) is one such outcome, characterized by changes resulting from struggling with trauma that leave an individual or community with improved wisdom, strengths, or skills in certain areas that they would not have gained without struggling with trauma. The current study looked at PTG among women in residential treatment for substance use and mental health concerns. All women were also pregnant or had a child under one year of age. Pregnant and new mothers are a particularly high-risk group for negative outcomes related to substance use. This was the first study to assess PTG among women who use substances. Participants were 104 women in a six-month residential treatment in central California from 2012-2015. Services included substance use recovery interventions, trauma interventions, parenting education, and individual and group counseling. Ninety-eight percent reported at least minimal PTG; the mean growth score was the equivalent of between a moderate and great degree of growth. Results demonstrated no relationship between trauma symptoms or change in substance use severity and PTG scores. However, consumer satisfaction was related to PTG, with greater satisfaction being related to higher levels of PTG.