A qualitative study of how maternal morbidities impact women's quality of life during pregnancy and postpartum in five countries in sub-Saharan Africa and South Asia.

Aim: Maternal morbidities present a major burden to the health and well-being of childbearing women. However, their impacts on women's quality of life (QoL) are not well understood. This work aims to describe the extent to which the morbidities women experience during pregnancy and postpartum affect their QoL and identify any protective or risk factors. Methods: This qualitative study included pregnant and postpartum women in Kenya, Ghana, Zambia, Pakistan, and India. Data were collected between November 2023 and June 2024. Participants were selected via purposive sampling, with consideration of age, trimester, and time since delivery. A total of 23 focus group discussions with 118 pregnant and 88 late (≥6 months) postpartum participants and 48 in-depth interviews with early (≤6 weeks) postpartum participants were conducted using semi-structured guides developed by the research team. Data was analyzed using a collaborative inductive thematic approach. Results: Four overarching themes were identified across pregnancy and the postpartum period: (1) physical and emotional challenges pose a barrier to daily activities; (2) lack of social support detracts from women's QoL; (3) receipt of social support mitigates adverse impacts of pregnancy and postpartum challenges on QoL; and (4) economic challenges exacerbate declines in women's QoL during pregnancy and postpartum. Conclusions: Bodily discomfort and fatigue were near-universal experiences. Physical and emotional morbidities related to childbearing limited women's ability to complete daily tasks and adversely impacted their perceived QoL. Social and financial support from the baby's father, family and/or in-laws, community members, and healthcare providers are important to mitigate the impacts of pregnancy and postpartum challenges on women's health and well-being.