Getting COVID-19 while pregnant comes with a series of risks. Pregnant people who are infected have a higher risk for severe illness — and, according to a new meta-analysis of 12 studies involving more than 13,000 pregnant women, a “significantly increased” risk of maternal death compared to uninfected pregnant women — as well as pregnancy complications, preterm births and stillbirth, according to the Centers for Disease Control and Prevention.

Despite the high stakes, vaccination rates remain low for this vulnerable group.

Research has shown that compared to women who were trying to conceive, breastfeeding and other women in general, pregnant women had the lowest vaccination rates — about 30 percent of pregnant women in the U.S. have not completed the primary vaccine series — and vaccine acceptance is “significantly lower” during pregnancy.

As a result, health organizations, including the American College of Obstetricians and Gynecologists and the CDC, continue to encourage pregnant people, or those thinking about becoming pregnant, to get vaccinated.

So what’s causing this vaccine hesitancy in people who are pregnant? Experts break it down.

Why are pregnant women in particular experiencing COVID vaccine hesitancy?

Some of the hesitancy may stem from the fact that initially, pregnant people were excluded from clinical trials for the vaccines and, as a result, had less confidence in their safety.

Dr. Alisa Kachikis, maternal-fetal medicine specialist and assistant professor in the department of obstetrics and gynecology at UW Medicine, points out that it’s “very normal” for pregnant people to ask questions about any medications and vaccines during pregnancy because they “want to do the best thing possible for their babies.” She tells Yahoo Life, “There are always questions about any vaccine that is recommended for pregnancy.”

In the case of the COVID vaccine, she says, “initially there were concerns because only a little bit of safety data was available when pregnant people became eligible for COVID-19 vaccines,” adding that now we have “really robust data on the safety of COVID-19 vaccines given during pregnancy, especially compared to the risks of having COVID-19 infection during pregnancy.”

Underestimating the actual risk of illness is another possible factor. “Pregnant individuals are typically young and healthy,” Dr. Mark Turrentine, professor of obstetrics and gynecology at Baylor College of Medicine and Texas Children’s Hospital, tells Yahoo Life. “There perhaps are misperceptions that they will not ‘get ill’ from this condition. This feeling of being ‘protected’ coupled with vaccine safety concerns or mistrust — although not founded — of a ‘new’ vaccine leads to the underutilization of this preventive measure.”

How vaccine misinformation and anxiety create the ‘perfect storm of concern’

Both experts and organizations, including the Kaiser Family Foundation, point to “widespread” misinformation as a key culprit behind vaccine hesitancy. Turrentine says that some pregnant people have “absolutely” fallen victim to misinformation about COVID vaccines.

“While social media outlets can be an easy way to access information, it is not filtered,” Turrentine says. “Unfortunately, sensationalism draws attention. So claims not supported by evidence may make good headlines — or lead to more clicks to links — and the misleading information can result in harm to the individual,” including recommendations to not get vaccinated while pregnant.

According to the Kaiser Family Foundation, about 3 in 10 women who are pregnant or planning to get pregnant believe at least one of three false statements about pregnancy and the vaccines, such as “Pregnant women should not get the COVID-19 vaccine” and “It is unsafe for women who are breastfeeding to get a COVID-19 vaccine,” as well as “COVID vaccines have been shown to cause infertility” — none of which are true.

“Without a doubt, pregnant people are particularly vulnerable to the misinformation regarding the COVID vaccine,” Dr. Michael Cackovic, maternal-fetal medicine specialist and clinical associate professor of obstetrics and gynecology at the Ohio State University Wexner Medical Center, tells Yahoo Life.

This is likely due to increased feelings of anxiety that can come with pregnancy. “While there is a lot of joy with pregnancy, it is also a time of change and responsibility,” Cackovic says, “and over 10% of pregnant people complain of increased anxiety. Add this to all the misgivings about the COVID vaccine that are rampant, and you have a perfect storm of concern over your pregnancy and baby.”

How safe are COVID vaccines for pregnant people?

COVID-19 vaccines are safe and effective for people who are pregnant, per the CDC. As of Jan. 7, 2023, nearly 72% of pregnant people in the U.S. have received the COVID vaccination before or during pregnancy, notes Turrentine. “So millions of women have been immunized with the COVID-19 vaccine, and no safety concerns for either the mom or baby have been noted,” he says.

Research shows that getting vaccinated while pregnant helps protect both the mother and the infant (thanks to maternal antibodies that are passed to babies in utero and through breast milk), which reduces the risk of COVID-related hospitalization in those younger than 6 months old. This is particularly significant since babies under 6 months of age aren’t yet eligible for COVID vaccines.

Kachikis explains that one of the “wonderful” functions of the placenta during pregnancy is to help protect newborns from infection “by transferring as much of the mother’s antibodies, or germ fighters, to the baby as possible while still in utero. When the baby is born, the mother’s antibodies in the baby help protect babies from really severe disorders like neonatal tetanus and whooping cough.”

Getting the full COVID-19 series and especially a booster can increase COVID antibody levels in pregnant people to provide even more antibodies for the placenta to transfer to their babies, says Kachikis. “This is a great way to provide the best start possible for newborn babies in terms of COVID-19 protection,” she adds.

Turrentine says that it’s important to weigh your personal risk when it comes to COVID and that pregnant individuals “should be allowed to make their own decision” as to whether to receive the vaccine. “Having said this, I would encourage all pregnant women to protect themselves from a virus that could be potentially life-threatening to themselves and harmful to their unborn child,” he says.

Cackovic agrees, saying: “The vaccine is our best defense against viruses, as always. They are safe, proven and effective. Getting vaccinated should be your first step in protecting your new baby.”

Wellness, parenting, body image and more: Get to know the who behind the hoo with Yahoo Life’s newsletter. Sign up here.