TABLE 2. THEMES DESCRIPTIONS AND EXEMPLAR QUOTES.

Themes and Subthemes	Description	Exemplar Quotes
Themes
Sense of Loss	Mothers noted they experienced a sense of loss about birthing alone, canceled or changes to their birthing plans, or the fear and worry from the pandemic.	Because of COVID-19, no one other than the spouse was permitted at the hospital with me, so [husband's] grandparents had to meet him via FaceTime. On the day [baby] was released from the hospital, Ohio was placed on lockdown, and everyone was mandated to stay home. For that reason, [baby] has not yet met his grandparents, aunts or uncles, nor close friends. Triage says, ‘okay, we want to keep you, but by yourself.’ When they said that, I lost it. I started crying. I was so upset. It was like a slap in the face. This is my time, you know, you see those videos, and you all are telling me I have to be alone?
Hospital Experience	Mothers described their experience with changes to hospital policies in response to the pandemic.	Going in, I was told obviously we have to wear a mask. And I was going to get the COVID test and not my husband or your partner because they said, if I have it, the chances are he has it. So, we walk through the hospital, and we get a temperature test and a classic questionnaire. And I was like, well, maybe that was the only test that we need, which is great because I was nervous about getting the thing stuck up my nose. At the OB, they had told us that they were giving people the option to test for COVID, and then when we got to the triage, they were like we're testing for COVID. It wasn't an option. As soon as we walked in, we were given a mask. And we had to wear a mask the entire time that we were there. The only exception was when we were in our recovery room, and it was just me and [husband]. But every time a nurse would come in, we had to put the mask on. And I had to wear the mask during the C-section, which was, oh my gosh, that was a mess, honestly.
Experience with Health Care Professionals	Mothers described their experiences with nurses, midwives, and obstetricians.	She [doctor] told me that at least I tried to have him naturally and that if we saw that anything was going wrong but I did not dilate and it had been hours and it was not going smoothly then she would do the c section so that made me feel really comfortable and I told her that she was the expert. It was a beautiful experience because the Matrona (midwife), which is the nurse, she was like next to the doctor just checking on me. There was a moment while I was pushing, she like got on top of me like to help push over my belly and she was like really comforting, she told me she was going to lower the light so that I can feel more calm and it was just a beautiful experience, and I'm so glad. Another mom echoed the same point: There was one nurse next to my head which I wish that I remembered what her name was because this lady was fantastic, I'm so glad that she was there with me cos she was great.
Overall Birth Experience Subthemes
Positive COVID-19 Cases versus Nonpositive COVID-19 Cases	Testing positive for COVID-19 created an unsatisfactory care experience.	We know you have three negatives [COVID tests] back, but we will still treat you like you have it. The nurses were like they didn't want to spend a lot of time in the room, and the lactation nurses declined to come to see me.
Hospital Birth vs. Home Birth	Some mothers opted for home birth rather than birthing in the hospital to prevent getting the virus.	This coronavirus is a chaotic time, I had [...] fears. I had to last-minute change my birth plans to help me feel comfortable in giving birth.
Bonding with Partner	Hospital policies limiting visitors allowed women to bond with their partner and baby better.	I could also see a lot of positive things, so if any of you guys are going through that [not having family members around] instead of looking at the negative side, look at it as a really strong bonding moment with your husband. It's actually truly beautiful to be able to share that with your partners. Honestly no offense to any family that may be watching this. But that [no family and friends hospital policy] was the most peaceful hospital experience ... oh my god I loved it.
Having a Healthy Baby	Having a healthy baby diffused the negative feelings of loss from the pandemic.	The main thing was we wanted to have a healthy baby, and all of the things that I missed out on all the craziness that was happening like none of it mattered when it just came down to like the point of all this is for us to just have a baby. All these other things like baby showers and photos and trips like none of that mattered in the midst of just like having a baby.
Mentally Prepared	Mental preparation for the worst outcome possible (e.g., birthing alone) allowed women to affirm strength and power over their minds and bodies.	So I was already kind of mentally preparing myself, and I was telling myself like you are strong, you've got this. You giving birth alone is not the end of the world it's not the biggest deal. You are going to be really proud of yourself so I kept telling myself things like that.
Faith	Faith in God enhanced coping skills to mitigate stress and worries.	God is just so good because anything could have happened. He works everything out, so I'm just so grateful that He did what He did and everything worked out.
Technology	Use of video calling to speak to family members during the birthing process or see their babies that were in the neonatal intensive care unit (NICU).	What I do like that my hospital did was they FaceTimed me. They had like an iPad there, and they will call me and update me and show me my baby [in the NICU].
Self-Advocating	Need to self-advocate when the care team was not paying attention to needs.	I live 35 minutes away from the hospital, so it's like, why are they sending you home? That doesn't make any sense [...] I kept advocating like hey do you want to keep me [...] even my sister called them to talk to them, and they were like “no.” She also said, “stay home because of COVID-19 or go to the hospital because you know your baby is coming.”
Importance of Timely and Effective Communication	Mothers reported poor communication with their health care providers; one titled her story Traumatic Birth Story During Pandemic!	I don't know what to think, you know I'm asking like can someone just let me know what is going on because they're not telling me anything like they're talking amongst themselves, but they're not telling me anything.
Postpartum Adjustment	Struggle to adjust to the postpartum period	I was just so emotionless, I just didn't have, I wasn't feeling anything [...], I was just really numb [...], and I pretty much didn't sleep, I sat in the toilet expressing colostrum and feeling sorry for myself. Honestly, during the first month of having a baby, I was topless for most of the day and those first couple weeks I definitely had like the baby blues, and I felt like I just cried all the time.
Maternal Health Conditions	Women with seemingly healthy pregnancies notified of a potentially threatening health condition.	I was supposed to be here just for an ultrasound, and I'm just here [now going to have an emergency cesarean], and I'm not going home.
Child Health Conditions	Mothers who had an adverse birth outcome noted how hospital visiting policies made their birthing experience particularly difficult.	Because of COVID-19 guidelines, the hospital basically said to us that only one parent per 24 hours could visit the [baby]. I don't understand how you could not see your baby and how you could choose which parents [are] more valuable and which parents should go. I wasn't able to be in the NICU with my husband [...], the hard thing about the NICU that was really hard for us that as soon as I went in to go see baby [name], partner [name] had then lost his right to go see him [baby] due to COVID.
Limited Knowledge about Childbirth	Limited information about labor and birth	I feel like people go into this black hole of labor and delivery. Two days before I delivered, I was half a centimeter, I've never heard of half a centimeter before.