Why COVID-19 vaccines and boosters are crucial for pregnant women

But she didn't feel comfortable going ahead with the jab without an understanding of whether it was safe.

"When I had my 14-week appointment with the midwife, she asked me whether I was vaccinated and I said, 'No, I'm not'," Ms Mills said.

"And then, just briefly over the phone, she reminded me that it's actually recommended for pregnant women and that she can send me through some resources, if it helps me make my decision."

Ms Mills was not alone in her hesitancy. Expectant mothers have been reported as one of the most hesitant groups to get vaccinated and there has been a lot of misinformation spread about the impact of vaccines on pregnancy.

Receiving research direct from her midwife was crucial for Ms Mills, who said pregnant women interested in vaccination faced walls of information that could be intimidating.

"I think if you're starting from a Google search, you'll probably feel a little bit overwhelmed, because there's a lot of scholarly articles, and then there's a lot of Reddit-style forums," she said.

"So you kind of get tied up in that, and that's why it was really nice of my midwife to send me a very small piece of information, which had [everything] that I needed."

Ms Mills was glad to have made the decision to get the vaccine after back-to-back exposures at her son's childcare centre sent the family into isolation twice.

"I feel a bit relieved, I kind of feel a little bit one step ahead, given that these kids actually can't get vaccinated themselves," she said.

During the early rollout of the vaccine pregnant women were only offered the vaccine if they were at higher risk of contracting COVID.

This was because pregnant women were not included in the initial clinical trials for the Pfizer vaccine.

Despite an initial lack of data on the impact of COVID-19 vaccines on pregnant women, studies ultimately confirmed it was safe and the advice was completely flipped on its head.

Expectant mums were strongly urged to come forward and the Commonwealth Health Department said limited protection could even be passed on via the placenta or breast milk.

Canberra Health Services acting clinical director of obstetrics Natalie De Cure said at first the sudden change in advice made it difficult for health professionals to encourage expectant mothers who were already hesitant to come forward for a vaccination.

She said significant work was undertaken to inform pregnant women of the change in advice and to ensure productive one-on-one discussions at various check-ups.

However, the vaccine had largely been taken up with gusto in Canberra.

"In the last few weeks, it's rare to come across a pregnant woman who's not vaccinated," Dr De Cure said.

"I feel like the pregnant women in Canberra have really gotten on board with it.

"Every now and then we do come across a woman [who is hesitant] and then we just spend a lot of time exploring their concerns and coming up with a plan that works for them."

One of the main messages for expectant mothers to understand was pregnant women were more susceptible to falling severely ill with the virus.

In England, since July one in five of some of the most critically ill COVID-19 patients were pregnant women who were unvaccinated.

The National Health Service in England last month revealed nearly 20 per cent of patients receiving treatment through a special lung-bypass machine were expectant mums.

Dr De Cure said COVID-19 could have devastating consequences for both the mother and the baby.

"We know that if we compare pregnant women to non-pregnant women of the same age group with the same medical risk factors in their background, pregnant women who contract COVID are much more likely to by symptomatic and much more likely to need hospitalisation and intensive care treatment," she said.

"Every time you have a critically ill mother that comes with risk to the baby as well.

"We've seen increased rates of pre-term birth and most of the time that's because the care team has had to make a decision to deliver a baby to improve outcomes for the mother so we can really treat the mother more effectively.

"But also there has been sudden stillbirth or babies that don't grow very well in pregnancy because of the huge impact that the infection has on a mum."

Misinformation about the impact of vaccines on fertility and pregnancy has also been rife and caused reluctance among women.

Rumours the COVID-19 vaccine caused women to be infertile spread through social media, causing even more apprehension among some women.

"There are two groups of women that impacts; it's the ones who are trying to fall pregnant and are having trouble or the ones who are already pregnant in very early pregnancy and are concerned about miscarriage," Dr De Cure said.

"There's been a lot of anecdotal stuff out there about impacts on periods or cycles or changes to menstrual cycles but when we look at the data there's been no verification of any impact on fertility and no reduction in fertility rates amongst women who've had Pfizer."

As the booster shot rollout gets under way in Australia, authorities encouraged pregnant women to come forward and get the jab.

COVID-19 boosters became available to all Australians last Monday, and more than 200,000 third doses have been administered in Australia.

But as the Australian Immunisation Register did not log whether a recipient was pregnant, the number of expectant mothers to have come forward was not known.

Health Minister Greg Hunt urged pregnant women to come forward for a booster.

"I would encourage women who are pregnant now, trying for a family or thinking about starting a family to get vaccinated, if you haven't already done so," he said.

"Vaccination is the best way to protect you and your family from COVID-19 and to ensure you remain protected, please come forward and receive a booster shot when it's your time to do so."

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Only Pfizer and Moderna have been approved for use for pregnant women as there has been limited research on the AstraZeneca vaccine in this cohort.

Australia's chief nursing and midwifery officer Alison McMillan said any woman aged 16 or over could safely receive Pfizer or Moderna at any point in their pregnancy.

"We have learnt from real-world evidence growing around the world that pregnant women are at a higher risk of severe illness from COVID-19 and unfortunately, it can cause the premature birth of their babies," she said.

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