Background <p>Preterm birth is a major public health concern and has serious implications for the mental health of mothers. Notwithstanding the growing evidence of its impact on child health and maternal risk factors, the voices of mothers are less heard regarding motherhood experiences and mental health. Using the phenomenological design, we explored the complex intersections of preterm motherhood and maternal mental health in a low-resource setting.</p> Results <p>Our findings revealed the following themes: impromptu motherhood (unpreparedness for emergency delivery and abrupt transition into preterm motherhood), traumatic motherhood (emotional and psychological stress and comparative experiences of term vs. preterm infants), complex caregiving dynamics (high parental burden, health and developmental concerns, and financial strain), and positive adaptation and support (support from family and healthcare and positive impacts of caregiving).</p> Conclusions <p>Preterm motherhood is a complex journey, marked by fear, exhaustion, and financial strain, but also by resilience, adaptation, and growth. The study has implications for maternal mental health promotion, public health research, and policy.</p>