Pregnancy comes with a long list of restrictions, and it can be hard to sort out which ones are backed by real evidence and which are overblown. The short answer: you need to avoid alcohol entirely, limit caffeine to 200 milligrams a day, skip certain foods that carry infection risk, stay away from common painkillers like ibuprofen, and modify some physical activities. Here’s a clear breakdown of what actually matters and why.
Alcohol: No Safe Amount
No amount of alcohol has been established as safe during pregnancy. The CDC recommends that pregnant women not drink at all. Alcohol crosses the placenta and can damage a developing baby at any stage, causing a range of lifelong physical, cognitive, and behavioral problems known as fetal alcohol spectrum disorders. These effects are entirely preventable by not drinking, which is why the guidance is absolute rather than “just have a little.”
Caffeine: Stay Under 200 mg
You don’t have to give up coffee completely, but you do need to watch the total. Both the American College of Obstetricians and Gynecologists and the American Pregnancy Organization recommend staying under 200 milligrams of caffeine per day. That’s roughly one 12-ounce cup of brewed coffee.
Keep in mind that caffeine adds up from multiple sources: tea, soda, chocolate, energy drinks, and even some medications and supplements. If you’re a multi-cup-a-day person, switching to half-caf or replacing some servings with decaf can help you stay within the limit without going cold turkey.
Foods That Carry Infection Risk
The biggest food concern during pregnancy isn’t nutrition, it’s foodborne illness. Listeria, a bacterium that can cause miscarriage, stillbirth, and serious newborn infections, is the main reason behind most pregnancy food rules. Your immune system is naturally suppressed during pregnancy, making you more vulnerable to infections that might not affect you otherwise.
Soft and Deli Cheeses
Soft cheeses made from unpasteurized (raw) milk are off the table. That includes brie, camembert, blue-veined cheeses, and queso fresco. The CDC goes further with queso fresco-style cheeses like queso blanco and requesón, advising you to avoid them whether they’re made with pasteurized milk or not, because their high moisture content makes them hospitable to listeria even after pasteurization. Unheated deli-sliced cheese also carries risk.
Hard cheeses made with pasteurized milk, like cheddar, parmesan, and Swiss, are fine. So are cottage cheese, cream cheese, feta, mozzarella, and string cheese when made with pasteurized milk. If you want soft cheese, heating it to 165°F (steaming hot) kills listeria.
High-Mercury Fish
Fish is actually recommended during pregnancy for its omega-3 fatty acids and protein. The FDA advises eating 8 to 12 ounces per week from lower-mercury options. A serving is about 4 ounces, roughly the size of your palm, so you’re aiming for two to three servings weekly.
Fish to avoid entirely because of high mercury levels: king mackerel, marlin, orange roughy, shark, swordfish, Gulf of Mexico tilefish, and bigeye tuna. Mercury can harm a baby’s developing brain and nervous system. Good lower-mercury choices include salmon, shrimp, tilapia, cod, catfish, sardines, and canned light tuna. Albacore (white) tuna has more mercury than light tuna, so limit it to one serving per week.
Other Risky Foods
Undercooked or raw meat, poultry, and eggs carry salmonella and toxoplasmosis risk. Cook meat to safe internal temperatures and skip runny eggs, raw cookie dough, and rare steaks. Deli meats and hot dogs should be heated until steaming to kill any listeria present. Raw sprouts (alfalfa, clover, mung bean) are another common source of bacterial contamination and are best avoided entirely.
Common Painkillers and Medications
Ibuprofen (Advil, Motrin), naproxen (Aleve), and other nonsteroidal anti-inflammatory drugs should be avoided from 20 weeks onward. The FDA warns that these can cause kidney problems in the baby, leading to dangerously low amniotic fluid. Amniotic fluid is essential for lung, digestive, and muscle development. After 30 weeks, NSAIDs can also cause heart problems in the baby.
Acetaminophen (Tylenol) has traditionally been considered the safer option for pain relief during pregnancy, though recent research has raised some questions. The one exception among NSAIDs is low-dose aspirin (81 mg), which is sometimes specifically prescribed for certain pregnancy complications like preeclampsia risk.
Beyond painkillers, many prescription medications are unsafe during pregnancy. Acne treatments containing retinoids (like isotretinoin) are known to cause severe birth defects. If you take any regular medications, reviewing them with your provider early in pregnancy is essential.
Skin Care Ingredients to Watch
Your medicine cabinet deserves a quick audit. The American Academy of Dermatology flags several common ingredients. Salicylic acid at concentrations above 2% should be used sparingly or avoided. Retinol and retinoid products, found in many anti-aging and acne treatments, should be stopped. Benzoyl peroxide, parabens, added fragrances, and harsh ingredients like alcohol-based toners and sulfates can cause irritation and are best minimized.
Gentle, fragrance-free products with ingredients like hyaluronic acid, glycerin, and vitamin C are generally considered safe alternatives for pregnancy skin care.
Hot Tubs and Overheating
Raising your core body temperature too high, particularly in the first trimester, has been linked to an increased risk of neural tube defects. Hot tubs and saunas are the primary concern because they can push your body temperature up quickly and keep it elevated. If you use a hot tub, limit your time to 10 minutes or less and avoid water above 100°F. Regular exercise, by contrast, doesn’t typically raise core temperature into the danger zone.
Sleeping on Your Back
In the second and third trimesters, lying flat on your back can compress a major blood vessel that supplies blood to your uterus. This can make you feel dizzy and may reduce blood flow to the baby. Sleeping on your side, particularly the left side, is the standard recommendation. A pillow between your knees or behind your back can help you stay comfortable and keep from rolling over during the night. If you wake up on your back, don’t panic. Simply shift to your side.
Physical Activities With Impact or Fall Risk
Exercise during pregnancy is encouraged, not restricted. Walking, swimming, stationary cycling, prenatal yoga, and even running (if you were a runner before pregnancy) are all fine for uncomplicated pregnancies. There’s no established heart rate limit you need to stay under. The old advice about keeping your heart rate below 140 beats per minute was retired years ago.
What you should avoid are activities with a high risk of falls or abdominal trauma: contact sports like soccer, basketball, and hockey; downhill skiing; horseback riding; gymnastics; and anything involving a risk of being hit in the abdomen. Scuba diving is also off limits because the pressure changes can cause dangerous gas bubbles in the baby’s blood.
Travel Restrictions
Flying is safe for most of pregnancy, but airlines typically cut off travel at 36 weeks, and some set an earlier deadline. You may need a doctor’s note for flights in your third trimester. Cruise lines are more restrictive, often barring pregnant passengers after 24 to 28 weeks.
The bigger concern with travel is prolonged sitting. Pregnancy already increases your risk of blood clots, and long flights or car rides compound that risk. On flights longer than a few hours, get up and walk the aisle periodically, flex your feet while seated, and stay hydrated. Signs that need immediate attention during travel include pelvic or abdominal pain, bleeding, contractions, severe headaches, unusual swelling, vision changes, or vomiting.
Smoking and Recreational Drugs
Smoking during pregnancy increases the risk of preterm birth, low birth weight, placental problems, and sudden infant death syndrome (SIDS). Secondhand smoke carries similar risks at lower levels. Marijuana, regardless of how it’s consumed, is also advised against, as it crosses the placenta and may affect fetal brain development. Recreational drugs including cocaine, methamphetamine, and opioids can cause severe complications ranging from placental abruption to neonatal withdrawal syndrome.
Cat Litter and Certain Cleaning Products
Changing cat litter carries a small risk of toxoplasmosis, a parasitic infection that can cause serious problems for the baby. If you have a cat, have someone else handle litter duty, or wear gloves and wash your hands thoroughly afterward. Gardening in soil where cats may have been also carries this risk.
Strong chemical cleaning products with harsh fumes, like oven cleaners and certain paint strippers, are worth avoiding, especially in poorly ventilated spaces. Everyday household cleaners used in a ventilated area are generally fine.