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.

The authors have declared no competing interest.

This work was supported by Bill and Melinda Gates Foundation grant number [INV-002220 and INV-037626 to KPA, CTA, and SN INV-003601 to VA INV-043092 to SB INV-057220 to ZH INV-057218 to MPK K01TW012426 NIH/FIC to MBS INV-057222 to WM INV-041999 and INV-031954 to ERS and INV-057223 to SM].

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

All participants provided written informed consent or assent prior to participating. Study procedures were reviewed and approved or exempted by the Institutional Review Board (IRB) and Ethics Review Committee (ERC) at each participating institution, as follows: The George Washington University, United States (NCR235136) Kintampo Health Research Centre, Ghana (KHRCIEC/2023-32) Society for Applied Studies, India (SAS/ERC/MMS Study/2023) Kenya Medical Research Institute, Kenya (SERU 4882) Aga Khan University, Pakistan (2023-9286-26951) Christian Medical College Vellore, India (IRB Min. No. 15913) University of Zambia, Zambia (Ref No. 4442-2023) and the University of North Carolina at Chapel Hill, United States (Z32301).

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Transcript data will not be made publicly available given that it contains private and confidential information. However, all data collection tools and protocols will be made available on Open Science Foundation under the PRISMA Consortium (osf.io/qckyt).