Table 1 Participant quotations from interviews organized by theme

Pandemic-Related Challenges

Work Changes

“…So it's been, you know, over a year now [working from home]. So, I'm still trying to get adjusted, which is crazy. Cause it's been so long, but I'm still trying to, trying to adapt to it. I love it. Don't get me wrong…it just seems like it's more now because you know, I'm coming downstairs in my pajamas and you know, I'm not really as focused as I would like to be, which is affecting, you know, my job essentially. So yeah. That's why work stresses me out right now.”

Safety Precautions (vaccine, masks, social distancing)

“…I'm looking around like, why aren’t people wearing that mask? So it's like, I'm trying to have fun, but that's all I'm thinking about. …So it’s bittersweet … I want to start going out … Cause, you know, the world is opening back up, but a spike, bam, pregnant and being out right now. It's not working for me.”

Social Isolation

“…the isolation, you know. I've not hugged my mother and my dad, my niece, my nephews, my brother in over a year. I mean, my family takes COVID very seriously… So the few times I see them, everyone's wearing a mask. Thanksgiving everyone was wearing a mask. We were all eating in separate parts of the house because you can't eat obviously with a mask on,…it's just different. I often think what would my pregnancy have been like if it were without COVID. Having my husband to be able to come to appointments.”

Mental Health

“… I'm from Maryland…so we went up there to …just get away from, COVID, away from the stress of COVID, and of course, we took proper precautions and everything, but still like, how has COVID impacted because it's been a lonely ride, this ride has been so freaking lonely. Um, you know, because when you're pregnant, your family is able to celebrate with you. They're able to join in on different visits, on all kinds of things. But, with all the COVID protocols, it's made it a very lonely, depressing journey.”

Hospital Restrictions

“…typically my parents would be there. My brother and sister-in-law would be waiting after the baby's born and you know, that's not possible, so it's definitely a different kind of experience.”

Vaccine Hesitancy

“Well, when they first had the vaccines, I was like, ‘oh no, nope, nope, not me.’ So it never even crossed my mind, but just because I've known a lot of people that know people that have died and they've gotten really, really sick. I was just talking to my doctor and asked her what she thought. And she was like, absolutely a hundred percent I recommend it, but I [was] nervous cause there's not, I just feel like it hasn't been out long enough to know what it's going to do to unborn…I just feel like it personally hadn't been out long enough for me to even get it.”

Coping: Social Support

Family & Friends

“I would say my mom had talked to her almost, oh, used to be every day, but now it's, I've been so busy that it's been less and less…probably like every other day I speak with my mother-in-law, believe it or not, a lot. I speak with my husband's grandmother, too; she’s 90. I chat with her a lot on the phone. And…there is a couple of other friends that I have here in Charlotte that I try to keep up with as well as some church brothers and sisters that I have to talk to.”

Church Community

“…In church Sunday, the sermon, um, the pastor was talking about purpose being inside of us all… And I thought about that figuratively, but also literally, that I have a baby inside of me, and there is purpose for her life. I can't wait to see what she does and the impact that she will have on me, my husband, but just on anyone that she encounters…”

Healthcare Providers

“And, and my previous appointment with my OB before this appointment, she really did have, like, um, a tough talk with me. Not, not in a negative way, but a necessary way, because she was just like, I'm starting to get worried about you because you are worried about everything like beyond what you really should. And, you know, she was just like, that's not good for you. That's not good for the baby. Like you need to enjoy your pregnancy.”

Online Community

“The ‘what to expect’ [mobile] app. I live in this little community tab here. There were just so many posts about insomnia and can't sleep, and it's like, [an app member] said, it's ruining my life. And I'm like, I'm right there with you. I know what that's like. …So, it was just me offering any advice at 1:38 in the morning. Hey, you're not alone… Lots of posts like that.”

Prenatal Health Navigation

Monitoring Health

“Even with my doctor whom I've known, whom I've trusted, you know, I'm sitting here telling her, okay, well, remember I had this time last pregnancy, so let's check on this, this, okay. But I went one time, and they weren't even to check my blood pressure. If someone had a history of high blood pressure wanting to [receive] a blood pressure. …It just seems like nowadays these appointments are just rushed, and they cause, you know, they give you like 15 min, 20 min. And if you have other concerns, it's like, if you didn't call in with those concerns, you have to set another appointment, or you have to wait. So it was just like, and I don't know if everybody's going through that. I can only go by my own experience, but yeah. That's how I feel.”

Health Literacy

“I think one thing that I have working to my advantage is I am an educated person, and I am not afraid to be articulate about things that I see are problems, but that's not the case for all Black women. And that's not the case. If you don't know to, take notes about questions you have or, you know, to speak up. And I was in one of the groups on the, What to Expect App. And they were like, you know, my doctor just made me feel so stupid, or my doctor just wouldn't answer any of my questions, and I just feel so sad, and I just came home and cried, and I'm not looking forward to my next appointment.”

Questioning

“…there's a 20-min slot for this appointment. I'm taking the full 20 min because there's always things that I want to ask.”

Advocate

“…I think we all have a responsibility to try to help one another, even in the example of my cousin sending me that book, but of course, she sent me other resources… to help, to think about things that we are more likely to encounter in pregnancy, not due to racism, just health issues, different things like that. So you need to be active. You need to be doing this; you need to be doing that. So I just think, um, education and, you know, making sure that we're all doing our part.”

Representation in the Healthcare System

“…My doctor, within the Charlotte network, is a brown lady. She's Indian. So yeah, so like I said, I want to support all brown colors. If that's Black, Indian, you know, whatever Hispanic, uh, not saying that I don't support the white community, but I feel like we need a bigger push than they do.”