BACKGROUND: Seasonal influenza vaccination during pregnancy is effective in preventing serious maternal and infant respiratory illness, but published Australian audits are sparse concerning practice. AIMS: Guided by information gained from new mothers about obstacles to influenza vaccination in July 2010, an educational program for maternity staff and pregnant women was developed with the aim of improving vaccine uptake in 2011. METHODS: One hundred and ninety-nine new mothers in July 2010 and 240 new mothers in July 2011 on postnatal wards of a tertiary obstetric hospital were interviewed about whether influenza vaccine had been offered or given and about reasons why women chose for or against vaccination during pregnancy. RESULTS: Influenza vaccination increased from 30% in 2010 to 40% in 2011 (P = 0.03). Fewer women cited safety concerns for themselves or their babies after the 2011 educational campaign. Comments from 90 women in 2011 give grounds for speculation that the vaccination rate could have been as high as 78% if influenza vaccination had been integrated as part of hospital-based antenatal care. CONCLUSIONS: Influenza vaccine coverage during pregnancy is increasing but obstacles persist, especially absent or inconsistent advice from healthcare workers and lack of ready access during routine antenatal care.