Adverse childhood experiences (ACEs) have been linked with increased risk for postpartum depression, which subsequently can lead to poor maternal and infant outcomes. The present study investigated how different patterns of ACEs are associated with postpartum depressive symptoms and with use of depression screening services. A racially/ethnically diverse sample of low-income women (N = 427) in an urban, university hospital in the Mid-Atlantic region reported their ACEs, depressive symptoms, receipt of depression screening, and receipt of a postpartum home visit. Three latent classes of maternal ACEs were identified: Low ACEs (57% of the sample), High Parental Separation/Divorce (30%), and High/Multiple ACEs (13%). Participants in the High/Multiple ACEs classes reported the highest levels of depressive symptoms, followed by women in the High Parental Separation/Divorce class, then the Low ACEs class. There were no statistically significant differences in depression screening services used across the three classes. Findings highlight the importance of screening for maternal ACEs during the perinatal period and targeting depression prevention services based on ACEs. More specifically, findings suggest multiple types of ACEs at high levels may be a more important predictor of depressive symptoms postpartum than the specific types of ACEs that are experienced.