Table 2.

Organizing Themes and Basic Themes with Illustrative Quotes.

Organizing Theme	Basic Theme	Illustrative Quote Examples
An Unprecedented Lack of Support	Lack of in-person support from partners/family	1. A, a Latina woman whose child is less than a year old, explained her social struggles during pregnancy: “Definitely isolating, you know, no one coming to visit you, and then when you’re home, you know, no one’s coming to visit you then, only maybe immediate family, and that’s it. And even then, in all, it was very short, short lived. Like they were here, in my house, for like 20 minutes max, you know, just because we don’t want to risk anything, and you know, no baby shower, no, nothing like that either. So, it was definitely lonely.” 2. H, a Latina mother of one who was in her second trimester at the time of data collection, also revealed her isolating experience after delivery under the social distancing during COVID-19: “How did it like affect, having COVID, how did COVID-19 affect the pregnancy or afterwards? I think it goes back to like the loneliness of it. I think again like for my experience, I had her right in the middle like when everything was still shut down. So, you know, nobody really met her right away. Nobody, you know, like my mom. I stayed at my mom’s because I had a C-section but, like, even when my mom grabbed her like, you know, we have nurses in the family. So, like she had on a gown and like, completely PPE on, just because she was so afraid to give it to her because not much was known about COVID of the time. So, I again, I just think very isolating, the whole thing with COVID was just very isolating.” 3. T, an Asian American woman with one child, described: “I could just say I agree to about the good and bad of COVID like such as working from home. Some of the bad could be, you know, they really don’t want you going to the hospital. Like for example, my partner never even met my doctor. He did see one of the ultrasounds but that was with the genetic counselor. So, you know, I was all excited throughout the whole pregnancy in the beginning but you know, for a man not knowing and seeing it was kind of like, oh, it sucks. He can’t go to the doctor’s office with me to experience the ultrasound, so it took a little bit more time where he was able to go, which was another doctor so that, yeah, I agree with there’s good and bad and you know, cases are dropping but still the policies are that he’s not allowed in here.” 4. H, a Latina mother of one in her second trimester with her second child, shared a similar experience resulting from the restricted visiting policy at perinatal appointments during COVID-19: “Like, no one can come to appointments with me and no one can go to ultrasounds with me still at the hospital that I am at. So I don’t have anything to base it off of, because it’s the same, like even though we’re in like the fourth or fifth wave.”
	Lack of engagement with healthcare providers	1. Y, a Latina woman with three children, explained how even receiving the support she needed from healthcare providers was challenging: “It’s the time of the pandemic, so we can’t just go out and talk to somebody. We’re all stuck at home, and we deal with it the way we can…I didn’t have any help from them [providers] whatsoever and the emotional support. I am currently pregnant, and they just told me that I’m expecting twins and, you know, they gave me a bunch of information that I wasn’t prepared for. They kept saying this information after another, that it was so overwhelming. And I’m like, I think I was just getting rid of that depression and now I’m gonna go back to it because of all this information. But I think I would love for the providers to be a little bit more sensitive. I know it’s hard for them to not to give all the information at once, but then also be mindful of taking that information to us and what can we do to cope with all this new information? And I don’t know. I just thought it was very overwhelming, I ended up with a headache instead of excitement. Don’t get me wrong but it was just so much that I didn’t even know how to digest that the new information.” 2. H, a Latina mother of one who was in her second trimester at the time of data collection, also revealed: “I think right now, I think there just needs to be more like sympathy. I don’t think. And I don’t know if sympathy’s the right word, but more, maybe it is, like sympathy towards the situation. I mean, if you ask people who had kids five years ago, their experience is completely different than, you know, kids who were born during COVID. And I think that, that’s the one person that we have to talk to about all this. Like one, our fears of, what if we catch COVID? Or, like, just our fears of the different things that we have to do alone versus being, like, having our significant other with us. And, you know, I feel like it’s brushed off and it’s just kind of brushed off and just kind of pushed aside and it’s like, okay. Like, you know, you come in the appointment, do what you got to do, and get out. You know, and it’s like, well wait, all of these questions weren’t answered [by the providers], and I feel like I’ve been to three or four different ones now … and I think that there’s a lack of, um, lack of communication when it comes to that.” 3. R, a Black woman with one child, also shared: “I ended up contracting COVID during my pregnancy, and just how they [the providers] handled that situation really pissed me off, for like their care, and I just didn’t really appreciate, like, how my concerns or worries were kind of just like, swept under the rug. So, I had to make some changes. I also decided to hire a doula after that experience, because I felt like me being a person of color, I mean, our experiences are not the same and they have a tendency to be traumatic. It’s already a traumatic experience, but they, they could be even more traumatic because we’re not often treated the same.”
Blaming and Shaming of Perinatal People	Feelings of judgment from everyone regardless of the actions they chose to take during the pregnancy	1. T, an Asian American woman with one child, reflected on this very concern about the stigma around vaccination in retrospect after giving birth: “I was actually really glad that the vaccine wasn’t available to me until after I gave birth because I feel like I probably wouldn’t have gotten it while pregnant, and I didn’t get vaccinated until several months after it was available to me because I was still breastfeeding and there wasn’t a lot of research on it and I just wasn’t sure. And for me, I’m like was working from home. I’m like, I’m not going out anywhere so I would rather reduce my risk that way and just not be vaccinated. But that judgment from other people, I felt that too.” 2. K, a Black woman with one child, described: “But during the time, while I was delivering, the vaccine came up a lot and I’ll be honest, I was scared. You know, I didn’t know how the vaccine would harm or help or what reaction it would have to my baby. No, at the time they have the vaccine out for the adults but not for kids when I was delivering. So I was just scared, so I just like, “No, I don’t want it because I’m not sure what effects it would have on my child.” And I kind of got like looks you know, there’s a thing with unvax people versus vax people. And you know, the unvaxxed people are kind of looked at as “Oh, you’re the problem,” you know, but as a woman, you know, carrying a child, your first thoughts are always what’s best for my baby. You know, you’re always going to put your baby over you, you know, and I felt like I might have been discriminated a little bit against, you know, because I chose not to, because I didn’t know what affects about my child.”
	Feeling blamed for prioritizing own needs	1. K, a Black woman with two children, shared her experience: “I just wanted to add that in the moment of apologizing, you were also trying to bring a baby into this world. I was getting [an] IV in my left arm and the COVID test the exact same time. I was having contraction, and everyone was working. I was still a human and I was like “I’m in pain, can you stop?” and they didn’t listen and it was so bizarre. Everything happened, you know, the outcome was great. But in that moment of five minutes of turmoil, I was afraid that like, I was going to do something wrong or like do the wrong thing and then they [the providers] would like, just drop the ball. That did not happen, that was just my fear because Black women do die at an exponential rate than other.”
Institutional Policies Impacting Perinatal Experience	Lack of access to proper treatment, support, resources, and education	1. N, a multiracial AfroLatina woman and mother of one child, shared her experience as a result of the institutional policies in place for COVID-19: “When I had my 20 weeks check-up, they said, “oh, you could FaceTime your significant other or you can FaceTime a family member,” but then their computer went down. So it was always like ‘This is news that I want to share,’ but I’m really alone. Like I can’t share this. I can’t let somebody hear the heartbeat right now, it was a very isolating experience.” 2. M, an Indigenous woman with one child, revealed her struggle to establish regular perinatal treatment in the early stage of her pregnancy: “I was losing 15 pounds a week… and they [the ER providers] kept telling me that what I was going through is normal, and it clearly was not normal, and it was just really frustrating because I have to go to the emergency room maybe six times before they would get me in to schedule an appointment.” 3. J, a Black woman in her third trimester at the time of data collection, also expressed her concern: “I don’t want to get exposed to COVID or anything, but on the other hand, it’s like there were no childbirth classes and I was like, how do you not have childbirth classes? And so, I had to do research to find one.” 4. K, a Black woman with one child, described how she had to make some difficult decisions and strayed from her desired plan: “So, I ended up having to have an emergency C-section, going away from my plan and with COVID policies in place with the hospital. My entire birthing team was not able to come. So, I had to under emergency circumstances, like try to make the best decision of who would go with me into the hospital.”
	Lack of flexibility for treatment and other administration services	1. M, an Indigenous woman, described: “I just felt like some of them were a little unnecessary and you know, if I don’t have to go into a doctor’s office during COVID, why make me, you know, I kind of felt obligated to go and they were like you need to go get checked just to make sure everything’s right, and you’re not having other issues and rule this out rule that out, but if that’s not the case for me, I don’t need to go, you know, what’s the point?” 2. N, a multiracial person, described: “He’s [the baby] Asian, Latino and Black so I want to give my child an ethnic name so that he can relate to culture, so I told them [the hospital staff] to add two accent marks.… They’re like, ‘Okay well if you put the accent marks in, then you’re not going to get a Social Security number from us. We’re not even going to register for that. You’re going to have to do that on your own.’”
Recommendations		1. H, a Latina woman with one child who was pregnant at the time of data collection, discussed how greater emotional support and understanding is needed from healthcare professionals when a patient is navigating pregnancy during a pandemic: “I think right now, I think there just needs to be more like sympathy...I mean, if you ask people who had kids five years ago, their experience is completely different than, you know, kids who were born during COVID. And I think that, that’s the one person that we have to talk to about all this. Like one, our fears of, ‘What if we catch COVID?’ Or, like, just our fears of the different things that we have to do alone versus being, like, having our significant other with us. And, you know, I feel like it’s definitely brushed off.” 2. N, a multiracial AfroLatina woman with one child, recommended that healthcare providers take the time to solicit information for mothers: “One thing that I would recommend for physicians to do is to provide information before it’s asked. Ask the person like, ‘Oh, so are you looking into finding out the gender? Do you know what kind of diet you should be taking? Do you want to breastfeed? This is when your milk will come in,’ so that you’re not in the moment and you’re panicking like, ‘Oh, I can’t do this. I can’t do that,’ because we can if we are informed.” 3. K, a Black woman with one child, recommended that empathy training could be provided for all those who interface with patients: “I think one good solution would be to have maybe a training.... When you’re going into the healthcare field, no matter what your title is because I do feel like we’re looked at more so as dollar sign than actually humans, you know, so I understand that life isn’t great. We had a bad day or, you know, your patient overload is ridiculous, and we’ll call it off and now you have double the patients, you know, things happen, life happens, but still we’re all here, you know, to get it care. We would like to just treat it with a little more compassion. So I think that would be a training on how to just be more, regardless of the circumstances, be more sympathetic and compassionate to your clients. That might be a step in the right direction...maybe just a class on treat your clients as if they’re your children, you know, [as] if they’re your family members, you know, just be kind and you know considerate to them.”