Background: As evidence emerges about its safety and effectiveness, COVID-19 vaccine uptake among pregnant women and nursing mothers is of interest. This study assessed the level of knowledge and acceptance of COVID-19 vaccination among these cohorts. Method: A multicentre, descriptive cross-sectional study was conducted among attendees of antenatal and postnatal clinics. Pretested self-administered questionnaire which consists of 29 items that assessed perception and acceptance of vaccine was used to generate data following informed written consent. Data analysis: Data was analysed using the IBM Statistics version 26. Descriptive and inferential statistics was used to assess for factors that influence their choices. Statistical significance was set at P value ≤ 0.05. Result: Six hundred and forty women participated, 336 (52.5%) were pregnant and 304 (47.5%) nursing mothers. Only 54 (8.4%) of the women were willing to be vaccinated. Acceptance was driven by the desire to prevent severe disease or infecting others. The death of a family member from the virus (AOR 5.322; 95% CI 2.641-10.749; p<0.001) and age <30 years (AOR 1.862 95% CI 1.043-3.322; p=0.035) had significant influence on acceptance. Lack of trust in the government (53%), cost (48.2%) and safety issues (44.1%) were main reasons for hesitance.Conclusion: Hesitance to COVID-19 vaccination among pregnant and lactating mothers is high those who have comparatively less knowledge about Covid-19. This may be improved with concerted efforts in the dissemination of accurate evidence on vaccine safety in these women in various communities.