An Exploration of the Effect of COVID Restrictions on Maternity Care in Uganda

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown. Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. This period was chosen because it reflected the time of stringent restrictions on the movement of public transport and private vehicles. Semi-structured interviews took place via planned and recorded telephone calls or face-to-face, depending on the woman’s preference and distance to her place of residence. Data collection was stopped when data saturation was evident. Result: Eight main themes and 16 sub-themes were identified. The main themes were choice of place of birth, access to routine healthcare, fear and anxiety, assault, financial constraints, transport challenges, birth companion, and postnatal checks and immunization. Conclusion: Our findings suggested that fear of contracting COVID-19 in health facilities, personal security issues, and fear of harassment along highways or when traveling, created major limitations to accessing health facilities and maternity care. These fears were compounded by transport challenges, financial constraints, and the inability to pay.