Objective: The objective of this study was to identify factors related to satisfaction with virtual visits during pregnancy in an effort to prioritize intervention targets for pregnant women during the COVID-19 pandemic. Methods: The study relied on data obtained from pregnant women (N = 416) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to November 22, 2020. Using a cross-sectional design, this study examined factors including COVID-19 related experiences and prenatal care changes in association with patient satisfaction of virtual prenatal care. Results: Overall, women reported being very or extremely satisfied (27.9%) or moderately satisfied (43.5%) with their virtual prenatal experiences, however, 89.9% indicated a preference for in-person care under non-pandemic conditions. Those who completed the survey further into the pandemic were less satisfied with virtual prenatal care (β = − 0.127, p < 0.01). After accounting for this and other sociodemographic characteristics, COVID-19 pregnancy worries (β = − 0.226, p < 0.001) and the number of prenatal care changes due to the pandemic (β = − 0.137, p < 0.01) were associated with lower satisfaction. Conclusion: Our findings demonstrate general satisfaction with virtual visits among pregnant women in this study although in general women would prefer in-person care if it weren’t for a pandemic. Women worried about the impact of pandemic on their pregnancy, as well as those experiencing transitions in their prenatal care may need more information and reassurance. Additional studies are needed to understand the unmet needs through virtual care compared to in-person care.