Pregnancy comes with a surprisingly long list of restrictions, from foods and medications to skincare products and activities. Some of these are based on well-established risks, while others are more precautionary. Here’s a practical breakdown of what to skip and what to limit over the next nine months.
Foods and Drinks to Avoid or Limit
Certain foods carry a higher risk of bacterial contamination or contain substances that can affect fetal development. The biggest concerns are listeria, mercury, and alcohol.
Pregnant women are 10 times more likely than the general population to get a listeria infection, which can cause miscarriage, stillbirth, or serious illness in a newborn. The highest-risk foods include soft cheeses made from unpasteurized milk (brie, camembert, blue cheese, queso fresco, queso blanco), raw or undercooked meat and poultry, refrigerated smoked seafood, deli meats that haven’t been heated until steaming, and raw sprouts. Pasteurization kills listeria, so always check labels on soft cheeses.
Fish is actually encouraged during pregnancy for its omega-3 fatty acids and protein, but you need to avoid the species highest in mercury. The FDA lists seven fish to skip entirely: king mackerel, marlin, orange roughy, shark, swordfish, Gulf of Mexico tilefish, and bigeye tuna. Aim for 8 to 12 ounces per week of lower-mercury options like salmon, shrimp, tilapia, or canned light tuna.
Caffeine doesn’t need to be eliminated, but keep it under 200 milligrams per day. That’s roughly one 12-ounce cup of brewed coffee. Higher intake has been associated with miscarriage and preterm birth. Alcohol, on the other hand, has no established safe amount during pregnancy and should be avoided entirely.
Medications That Aren’t Safe
One of the most common surprises is that ibuprofen, naproxen, and other NSAIDs are not safe during much of pregnancy. After 20 weeks, these medications can cause kidney problems in the developing baby, leading to dangerously low amniotic fluid levels. Low fluid for a prolonged period can restrict limb movement and delay lung development. After 30 weeks, the risk increases further because NSAIDs can cause premature closure of a critical blood vessel in the fetal heart.
Acetaminophen (Tylenol) is generally considered the safer option for pain relief during pregnancy, though you should still use the lowest dose that works. Low-dose aspirin (81 mg) is actually prescribed for some pregnancy-related conditions, so that’s a specific exception to the NSAID rule.
Beyond pain relievers, many prescription and over-the-counter medications are off-limits. Acne treatments containing retinoids (like tretinoin and isotretinoin) are known to cause birth defects and must be stopped before conception. Don’t assume any medication is safe without checking first, including herbal supplements.
Skincare Products to Check
Retinoids are the biggest concern in skincare. These vitamin A derivatives, found in many anti-aging and acne products, are linked to developmental problems. Check ingredient lists for retinol, retinaldehyde, tretinoin, adapalene, and tazarotene, and stop using any of them.
Hydroquinone, a common skin-lightening ingredient, absorbs through the skin in relatively large amounts and should be avoided. Minoxidil, used for hair regrowth, is also not recommended during pregnancy. For acne, look for products with ingredients like glycolic acid or azelaic acid, which are generally considered safer alternatives.
Hot Tubs, Saunas, and Overheating
Anything designed to raise your body temperature significantly is off the table. Hot tubs, saunas, steam rooms, and hot yoga all pose a risk because elevating your core body temperature can interfere with healthy fetal development, particularly in the first trimester when the neural tube is forming.
Baths are fine, but keep the water at or below 99°F (37°C), which is warm enough to be comfortable without pushing your core temperature up. The key difference is that a bath cools as you sit in it, while a hot tub maintains temperatures of 100 to 104°F continuously.
Exercise Adjustments
Exercise during pregnancy is encouraged and beneficial, but a few types of activity need to be modified or dropped. After the first trimester, avoid exercising flat on your back. The weight of the growing uterus compresses a major blood vessel, reducing blood flow to both you and the baby. This rules out traditional crunches, certain yoga poses, and flat bench exercises. Propping yourself at an incline is a simple workaround.
Contact sports, activities with a high fall risk (skiing, horseback riding, gymnastics), and scuba diving should be avoided throughout pregnancy. Scuba diving exposes the baby to decompression pressure that its circulatory system can’t handle.
Cat Litter and Infection Risk
You’ve probably heard this one: don’t change the cat litter. The concern is a parasite called toxoplasma, which cats can shed in their feces. If you’re infected for the first time during pregnancy, the parasite can cross the placenta and cause serious problems including vision loss, brain damage, or miscarriage.
The practical advice from the CDC is to have someone else handle litter box duties entirely if possible. If that’s not an option, wear disposable gloves, wash your hands thoroughly afterward, and change the litter daily. The parasite takes one to five days after being shed to become infectious, so daily cleaning significantly reduces your risk. The same caution applies to gardening in soil where outdoor cats may have been, so wear gloves for that too.
Certain Vaccines
Live vaccines, which contain a weakened but active form of a virus, are not given during pregnancy because of a theoretical risk to the developing baby. The specific vaccines to avoid include:
- MMR (measles, mumps, rubella)
- Varicella (chickenpox)
- Live flu nasal spray (the injectable flu shot, which is inactivated, is safe and recommended)
- Yellow fever
- Live typhoid
If you need any of these vaccines, the standard recommendation is to get them at least four weeks before trying to conceive. For MMR specifically, the CDC recommends waiting 28 days after vaccination before becoming pregnant. If you’re in the middle of an HPV vaccine series when you become pregnant, pause it and finish after delivery.
Inactivated vaccines like the flu shot, Tdap (whooping cough), and COVID-19 vaccines are safe and often specifically recommended during pregnancy.
Hair Dye and Cosmetic Treatments
Hair dye is one area where the risk is lower than most people assume. The chemicals in permanent and semi-permanent dyes are present in very small amounts, and a healthy scalp absorbs very little. Most research shows it’s safe to color your hair during pregnancy. That said, some people prefer to wait until after the first 12 weeks, when the baby’s major organs have formed and the risk from chemical exposure is lower. Highlights and balayage, where the dye doesn’t touch your scalp, are another way to reduce any minimal exposure.
Alcohol and Smoking
No amount of alcohol has been proven safe during pregnancy. Alcohol crosses the placenta freely, and the developing baby metabolizes it much more slowly than you do. Exposure can cause a range of lifelong physical, behavioral, and learning problems grouped under fetal alcohol spectrum disorders. This applies to all types of alcohol equally: wine, beer, and spirits.
Smoking restricts oxygen and nutrient delivery to the baby through the placenta, increasing the risk of preterm birth, low birth weight, and stillbirth. Secondhand smoke carries similar risks, so avoiding smoky environments matters too. Vaping and e-cigarettes also expose the baby to nicotine and other harmful chemicals and are not a safe alternative.