Background: Limited qualitative research exists exploring the introduction of telehealth visits alongside in-person visits (mixed modality) for prenatal and postnatal care during the COVID-19 pandemic. This study aimed to understand the experiences of birthing people, providers, and leaders with mixed modality care at a large healthcare network in Northern California.

Methods: We implemented a qualitative study with birthing people, providers, and healthcare leaders across Sutter Health who received/provided prenatal and postnatal care between March 16^th and December 31^st, 2020. In-depth interviews were conducted in English over the phone or Zoom. Transcripts were analyzed in Dedoose using codebook thematic analysis.

Results: We conducted 65 interviews with leaders (N=8), providers (N=7), and birthing people (N=50). All groups highlighted internet connectivity as a primary challenge of telehealth implementation. The convenience and intimacy of being able to receive care in one’s own home without having to travel was noted by birthing people and providers as a strength. This was particularly significant during the pandemic, when family members were not permitted to accompany birthing people to in-person visits (a reality that all groups noted as necessary but deeply distressing). However, providers and birthing people described discomfort and fear with losing out on hands-on care (e.g. checking the fetal heartbeat, in-person lactation support) with telehealth.

Conclusion: Telehealth options for prenatal and postnatal care will likely remain beyond the pandemic. The distinct experiences of leaders, providers, and birthing people offer insights into the ways in which telehealth can be successfully integrated.