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Objective: This study describes the perceptions, personal and community experiences, and barriers to care of Somali-American families regarding specialized maternal-fetal care from their viewpoint., Study Design: We conducted a semi-structured focus group study of Somali-American women (March 2023). We used qualitative analysis techniques to identify and report thematic findings., Results: Fifty Somali-American women were interviewed in focus groups. Five themes were identified: 1) adherence to religious belief (namely Islamic) was paramount, including devotions of predestination (e.g. divine will) and permissibility of fetal intervention, 2) participants valued consensus among clinicians and were guided by prior experiences, 3) confidence in the medical team was important, and included the need to communicate effectively with clinicians and concerns regarding the accuracy of diagnosis, 4) decisional factors prioritized saving the life of the baby, and 5) treatment considerations included reluctance to intervene before birth., Conclusions: For the Somali-American participants, their faith identity was central when considering their medical needs, including a hesitance to treat a baby before birth due to Islamic belief in divine will. In addition, these community members highlighted the importance of trustworthy interpretation, cultural competence, clinician consensus, prior pregnancy experiences as well as experiences of other community members as having an impact on their trust in their medical care and diagnosis., (© 2024 John Wiley & Sons Ltd.)