Background: The current uncertainties and alarming situation of COVID-19 pandemic may cause anxiety, mental distress and fears among pregnant women, who otherwise may have been progressing well. Till date, there is no robust empirical evidence, how the COVID-19 pandemic might have influenced the generalized anxiety and fears among pregnant women.Objective: To determine the perceptions, anxiety and fears of current COVID-19 pandemic among pregnant women during antenatal and immediate postpartum period.Setting: Pregnant women attending antenatal outpatient department, or women who recently delivered at the Department of Obstetrics & Gynecology Unit II, Ruth Pfau KM Civil Hospital and Holy Family Hospital, Karachi were included in the study.Methods: A pre-designed, validated questionnaire was used by medical doctors through a face-to-face interview to collect the desired information. Associations were determined using parametric tests and a p-value ≤ 0.05 was considered as statistically significant.Results: A total of 286 pregnant women with a mean age of 26.47 ± 4.81 years were enrolled in the study. The mean gestational age of women was 33.04 ± 7.54 weeks. Majority of women 67.8% (n=194) perceived that COVID-19 can affect the pregnancy, it can be transmitted to newborn baby 83.2% (n=238), and can affect the child if mother has infected with this virus 84.6% (n=242). Most of the women 84.6% (n=242) were afraid of COVID-19 infection, and reported mean fear level of 5.86 ± 3.12 on a scale of 1 to 10. Women who perceived that COVID-19 can affect the child had significantly higher level of GAD scores (n=37, 15.3%, p-value 0.042). Similarly, women who were afraid of COVID-19 infection had significantly higher (n=40, 16.5%, p-value 0.046) GAD score. Women who had high GAD score (≥7) also had significantly higher (p-value 0.020) fear score (6.90 ± 3.23 vs 5.68 ± 3.07) compared with women who had normal GAD score (<7).Conclusion: High proportion of women had stronger belief that if mother have infection, child will also have it and it’s likely to be transmitted from mother to child. Although there is not enough evidence to support vertical transmission of infection as yet but it is still appearing as a major stressor among pregnant women.