Highlights

• Individual, interpersonal, community, institutional, and structural facilitators and barriers impact patient access to pre and postnatal care.
• Long-term relationships with clinicians and robust postpartum support were important to pregnant and postpartum participants.
• Patients defined trust as confidence in clinicians’ knowledge and ability and as a perceived obligation to comply with clinician instruction.
• Patients described prenatal appointments as causing joy and anxiety, and sought reassurance and connection from appointments.
• Patients were ambivalent about telehealth, citing convenience, safety, and lack of emotional connection as relevant.