Objectives. To assess COVID-19 vaccination rates among North Dakota residents who gave birth. Methods. We used data from North Dakota Vital Records and the North Dakota Immunization Information System for North Dakota residents who gave birth between April 1, 2021, and July 15, 2022. We evaluated vaccination with 1 dose, primary series, and monovalent booster for timing before and during pregnancy and postpartum. Results. Among North Dakota residents who gave birth, 44% received at least 1 COVID-19 vaccine, 34% received a complete primary series, and 10% received a monovalent booster dose. Among those who received a COVID-19 vaccine, the majority was vaccinated during pregnancy. Obstetrics and gynecology providers administered just 9.2% of COVID-19 vaccine doses. Conclusions. Most persons who gave birth in North Dakota did not receive the primary series of the COVID-19 vaccine while pregnant. Providers have an opportunity to counsel their pregnant and recently pregnant patients on vaccine recommendations. (Am J Public Health. 2024;114(2):237-240. https://doi.org/10.2105/AJPH.2023.307500).