To evaluate acceptance of a pandemic avian influenza vaccine among obstetric patients and nonphysician obstetric office personnel. Two separate office-based questionnaires were administered to patients and nonphysician personnel. Questions included demographics, vaccine beliefs and acceptance of a potential pandemic avian influenza vaccine in pregnancy. Questionnaires were completed by 394 of 600 (65.7%) eligible patients and 101 of 134 (75.3%) eligible office personnel. Only 15.4% of the patients stated they would definitely accept a pandemic influenza vaccine in pregnancy despite most (68%) reporting they would first consult their obstetrician for information. Fifty percent of the office personnel would not recommend a pandemic influenza vaccine to pregnant women and 40% reported unwillingness to accept the same vaccine if they were pregnant. Barriers exist that may hinder mass vaccination efforts among the pregnant population during the next influenza pandemic. Preemptive educational efforts may assist in the acceptance of a pandemic vaccine among pregnant women and enable obstetricians to better provide disease prevention during the next influenza pandemic.