Living with risk and uncertainty: a qualitative phenomenological study of women’s pregnancy and postpartum experiences in Saskatchewan during COVID-19

BACKGROUND: The COVID-19 pandemic disrupted maternal healthcare globally, yet localized experiences within structurally constrained settings remain underexplored. In Saskatchewan, Canada, pre-existing inequities relating to geography and health care access shaped how women experienced pregnancy and early motherhood during the pandemic. This study explored the lived experiences of women who were pregnant and gave birth during the COVID-19 pandemic, with particular attention to how healthcare disruptions, social restrictions, and structural conditions shaped care experiences, distress, and resilience. METHODS: This qualitative interpretive phenomenology study drew on 35 individual interviews and three focus group discussions with a total of 51 women who were pregnant or gave birth between March 2020 and December 2022. Participants were purposively sampled across urban, rural, and northern Saskatchewan. Data were analyzed using reflexive thematic analysis. RESULTS: Four themes were identified: living with pandemic risk and uncertainty; fragmentation of maternal care; emotional toll of isolation; and coping and resilience. Women described heightened fear and moral responsibility, disrupted access to prenatal and postpartum services, depersonalized communication, and limited mental health and lactation support, particularly in rural and northern regions. While virtual care improved accessibility for some women, it often lacked relational and embodied dimensions of care. Family support, trusted healthcare providers, and digital resources facilitated coping and resilience. CONCLUSION: The pandemic intensified existing inequities in maternal healthcare, revealing vulnerabilities in communication, continuity, and culturally responsive care. Findings underscore the need for equity-oriented emergency preparedness, hybrid models of care, strengthened maternal mental health services, and meaningful involvement of people with lived experience in planning future responses.