text: Facing the COVID 19 pandemic inside maternities in Brazil A mixed method study within the REBRACO initiative COVID 19 pandemic posed major challenges in obstetric health care services Preparedness development and implementation of new protocols were part of the needed response This study aims to describe the strategies implemented and the perspectives of health managers on the challenges to face the pandemic in 16 different maternity hospitals that comprise a multicenter study in Brazil called REBRACO Brazilian network of COVID 19 during pregnancy Mixed method study with quantitative and qualitative approaches Quantitative data on the infrastructure of the units maternal and perinatal health indicators modifications on staff and human resources from January to July 2020 Also information on total number of cases and availability for COVID 19 testing A qualitative study by purposeful and saturation sampling was undertaken with healthcare managers to understand perspectives on local challenges in facing the pandemic Most maternities early implemented their contingency plan REBRACO centers reported 338 confirmed COVID 19 cases among pregnant and post partum women up to July 2020 There were 29 maternal deaths and 15 51 8 attributed to COVID 19 All maternities performed relocation of beds designated to labor ward most 75 acquired mechanical ventilators only the minority 25 installed new negative air pressure rooms Considering human resources around 40 hired extra health professionals and increased weekly workload and the majority 68 7 also suspended annual leaves Only one center implemented universal screening for childbirth and 6 37 5 implemented COVID 19 testing for all suspected cases while around 60 of the centers only tested moderate severe cases with hospital admission Qualitative results showed that main challenges experienced were related to the fear of the virus concerns about reliability of evidence and lack of resources with a clear need for mental health support among health professionals Study findings suggest that maternities of the REBRACO initiative underwent major changes in facing the pandemic with limitations on testing difficulties in infrastructure and human resources Leadership continuous training implementation of evidence based protocols and collaborative initiatives are key to transpose the fear of the virus and ascertain adequate healthcare inside maternities especially in low and middle income settings Policy makers need to address the specificities in considering reproductive health and childbirth during the COVID 19 pandemic and prioritize research and timely testing availability 