This is an incredibly stressful time to be pregnant.

From restrictions on partners attending prenatal appointments, to the loneliness of pregnancy without in-person mom friends, to COVID-19 protocols in the delivery room—there are so many extra challenges facing new mamas.

News this week from the World Health Organization added a new layer of complexity for those navigating pregnancy in a pandemic.

Conflicting guidance from leading medical organizations

The World Health Organization, which guides global health policy, this week announced its recommendation that most pregnant women should not get the COVID-19 vaccine, only to later revise that recommendation.

The WHO now recommends that most pregnant should get the COVID-19 vaccine, saying "we don't have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women."

Their previous stance was based on the lack of existing testing in pregnant populations, and is considered to be a 'conservative' view of what to do, erring on the side of waiting for more information.

It based its recommendation on the lack of existing testing in pregnant populations, and is considered to be a 'conservative' view of what to do, erring on the side of waiting for more information.

Meanwhile, America's leading medical organizations for OB/GYNs, The American College of OB/GYNS (ACOG), issued a joint the Society for Maternal-Fetal Medicine (SMFM), reiterating its stance that the evidence they have supports their recommendation that pregnant women should get the vaccine.

"ACOG strongly advocated for the inclusion of pregnant people in the COVID-19 vaccine trials so that we would currently have the data to support the safety and efficacy of the vaccines in this population," ACOG's Vice President Dr. Christopher Zahn, MD, told Motherly.Pregnant individuals are often excluded from vaccine and other clinical trials because of ethical issues and concerns for risks to the fetus. However, in recent years, a new wave of medical experts have advocated for a more proactive approach to medical research during pregnancy, especially when the benefits of knowing that a treatment is safe are expected to outweigh the risks to mother and child.

ACOG explains what is known about COVID-19, vaccines and pregnancy

"Even in the absence of this data, pregnant people should know that the way the vaccines work and early evidence from animal studies gives us reason to believe that there should be no harmful effects to the fetus or female reproduction," Dr Zahn, MD, explains. "Additionally, both the Pfizer-BioNtech and Moderna vaccines are not live virus vaccines. They do not enter the nucleus and cannot cause any genetic changes. The safety of these vaccines were demonstrated in the clinical trials with non-pregnant individuals and it is expected that there will be similar results in pregnant individuals."

Pregnancy raises risks from COVID-19 virus

In a statement on its website this week, ACOG made clear that the virus itself does pose an increased threat to pregnant people: "Data have demonstrated that symptomatic pregnant individuals with COVID-19 are at increased risk of more severe illness and death compared with nonpregnant peers. Many pregnant individuals have medical conditions known to put them at further increased risk of severe illness and complications. Therefore, given clear evidence of the dangers of COVID-19 in pregnancy, an absence of data demonstrating adverse effects associated with the vaccine in pregnancy, and in the interest of patient autonomy, ACOG and SMFM recommend that pregnant individuals be free to make their own informed decisions regarding COVID-19 vaccination."

Moms and misinformation

The conflicting guidance is particularly problematic because studies show that women, particularly mothers, are more likely to be skeptical of vaccines than men. And with so many mothers being targeted by misinformation campaigns and conspiracy theories, it is more critical than ever that trusted public health organizations give the best guidance available.

That said, one defining feature of any crisis, including the COVID-19 pandemic, is that expert recommendations evolve when more information is known. We weren't all wearing masks in March of 2020, but when it became increasingly clear that the virus was spread by respiratory droplets, guidance was updated accordingly. We have to both follow the existing evidence and know that more information will come in.

How to decide what to do

ACOG also recommends that you factor the following components into your decision to vaccinate yourself (or not) during pregnancy: Any underlying conditions, your risk profile of contracting COVID-19 from your family, lifestyle or workplace and the level of outbreak in your community. In short, talk to your doctor or midwife about your particular circumstances to help you make the most informed decision.

Managing your anxiety through COVID-19

Diana Spalding, Motherly's Health & Wellness Director and a certified nurse-midwife, wants to help women spiraling through the stress of pregnancy in a pandemic.

"First, I want to acknowledge how stressful this situation is—not only are you pregnant during a pandemic, you are trying to make a decision amid conflicting (and changing) recommendations. I believe that the most important thing to remember is that we simply do not have enough information to make generalized statements regarding what pregnant people 'should' or 'should not' do about this vaccine—that means that you can feel empowered, with the guidance of your provider, to make the decision that works best for you and your specific situation."

And as more information comes in about COVID-19, vaccines and pregnancy, Motherly will share it. This article was originally published on January 28 2021 and has been updated.