Pregnancy requires rethinking a surprising number of everyday habits, from what you eat and drink to which skincare products you use and how you sleep. Some of these are well known (no alcohol), while others catch people off guard (your favorite face cream might need to go). Here’s a practical breakdown of what to avoid and why it matters.
Alcohol: No Safe Amount at Any Stage
There is no known safe amount of alcohol during pregnancy, and no safe trimester to drink it. That applies equally to beer, wine, and liquor. The CDC’s position is straightforward: zero alcohol from the time you’re trying to conceive through delivery. Alcohol crosses the placenta freely and can interfere with fetal development at any point, contributing to a range of physical, behavioral, and learning problems collectively known as fetal alcohol spectrum disorders.
Foods That Carry Real Risk
The biggest food dangers during pregnancy come from two pathogens: Listeria and Toxoplasma. About 50% of toxoplasmosis infections in the U.S. each year come from food, primarily undercooked meat. Listeria thrives in ready-to-eat foods that don’t get reheated. Both can cross the placenta and cause miscarriage, stillbirth, or serious illness in a newborn.
Foods to skip or handle carefully:
- Raw or undercooked meat, especially pork, lamb, and venison. Use a meat thermometer and wash cutting boards, knives, and hands thoroughly after handling raw meat.
- Deli meats and hot dogs unless heated until steaming. Listeria can grow even at refrigerator temperatures.
- Unpasteurized dairy and soft cheeses like queso fresco, brie, and camembert made from raw milk.
- Raw sprouts (alfalfa, clover, radish), which are frequent sources of bacterial contamination.
- Raw or undercooked eggs, including homemade Caesar dressing, raw cookie dough, and some hollandaise sauces.
- Refrigerated smoked seafood unless it’s in a cooked dish.
High-Mercury Fish
Fish is valuable during pregnancy for its omega-3 fatty acids, but certain species accumulate dangerously high mercury levels. The FDA lists these in its “Choices to Avoid” category: king mackerel, marlin, orange roughy, shark, swordfish, Gulf of Mexico tilefish, and bigeye tuna. Lower-mercury options like salmon, sardines, tilapia, and shrimp are safe to eat two to three times per week.
Caffeine
You don’t have to give up coffee entirely. The American College of Obstetricians and Gynecologists considers moderate caffeine intake, under 200 mg per day, unlikely to be a major factor in miscarriage or preterm birth. That’s roughly one 12-ounce cup of brewed coffee. Keep in mind that caffeine also shows up in tea, chocolate, soda, and energy drinks, so the total adds up faster than you might expect.
Medications and Supplements to Avoid
Common over-the-counter painkillers like ibuprofen (Advil, Motrin) and naproxen (Aleve) belong to a class called NSAIDs, and they carry specific risks at different stages. After 20 weeks, NSAIDs can impair the baby’s kidney function, which in turn reduces the amniotic fluid that cushions and protects the baby. After 30 weeks, they can cause premature closure of a blood vessel in the baby’s heart that’s supposed to stay open until birth. The one exception is low-dose aspirin (81 mg), which some providers prescribe for specific pregnancy complications.
For pain relief, acetaminophen (Tylenol) is generally considered the safer option, but it’s worth confirming with your provider. Beyond painkillers, check any herbal supplements, sleep aids, or allergy medications before continuing them. Many haven’t been studied in pregnancy, and “natural” doesn’t mean risk-free.
Skincare Products With Retinoids
Retinoids, the vitamin A derivatives found in many anti-aging and acne products, are one of the most well-documented causes of preventable birth defects. Prescription retinoids like isotretinoin (formerly sold as Accutane) can cause malformations of the skull, face, heart, and brain, with overall malformation rates in exposed pregnancies ranging from 5% to 20%. Affected infants may experience hearing loss, cleft palate, heart defects, and significant developmental delays.
While topical retinoids (retinol creams, adapalene gels) deliver a much smaller dose than oral medications, most providers recommend stopping all retinoid products before and during pregnancy as a precaution. Check your moisturizer, serum, and sunscreen ingredient lists for retinol, retinaldehyde, retinyl palmitate, adapalene, tretinoin, or tazarotene. Vitamin C serums, hyaluronic acid, and azelaic acid are commonly recommended alternatives.
Hot Tubs, Saunas, and Overheating
Maternal hyperthermia in early pregnancy is a known teratogen, meaning it can directly cause birth defects. Hot tub and sauna use during the first trimester has been linked to an increased risk of neural tube defects, which are serious malformations of the brain and spinal cord. The concern is raising your core body temperature above 101°F (38.3°C) and keeping it there.
A warm bath is fine as long as the water isn’t hot enough to make your skin turn red or make you feel overheated. If you’re sweating or feel dizzy, get out. The same principle applies to exercising in extreme heat or spending extended time in direct sun on hot days.
Certain Sports and Activities
Exercise during pregnancy is strongly encouraged, but some activities carry specific risks that outweigh the benefits. Contact sports like hockey, boxing, wrestling, football, and soccer are discouraged because of the risk of abdominal trauma, which can cause placental abruption (the placenta separating from the uterine wall). High-fall-risk activities like gymnastics, horseback riding, skiing, skating, and water skiing also make the avoid list.
Scuba diving is a firm no. The pressure changes create gas bubbles that the baby has no way to clear. Hang gliding and similar extreme sports are also out for obvious reasons.
Walking, swimming, prenatal yoga, stationary cycling, and light strength training are all safe for most pregnancies and help with everything from back pain to labor preparation.
Sleeping on Your Back After 20 Weeks
Once your uterus is large enough, typically around 20 weeks, lying flat on your back can compress the large blood vessel (the inferior vena cava) that returns blood to your heart. This can reduce blood flow to both you and the baby. You might notice dizziness, nausea, or shortness of breath if it’s happening.
Side sleeping, particularly on your left side, keeps that blood vessel clear. If you wake up on your back, don’t panic. Just roll over. A pillow wedged behind you or between your knees can help you stay on your side through the night.
Cat Litter and Toxoplasmosis
Cats that go outdoors and hunt prey can carry Toxoplasma parasites in their feces. If you have a cat like this, have someone else handle litter box duty every day during your pregnancy. If you have a strictly indoor cat that eats only commercial cat food and has no contact with outdoor animals, your risk is very low. You don’t need to rehome your cat, just delegate the litter box and wash your hands after petting outdoor cats.
Cleaning Products and Fumes
Heavy-duty cleaning doesn’t need to stop, but the way you do it matters. Spray and aerosol cleaners are the biggest concern. Prenatal exposure to spray cleaners has been associated with increased risk of childhood asthma, with ingredients like ammonia, chlorine, glycol ethers, and sodium hydroxide flagged as especially problematic. Air fresheners carry similar risks.
Practical adjustments: open windows when cleaning, switch from sprays to liquid or wipe-on products, wear gloves, and never mix bleach with ammonia or other chemicals. If you can smell strong fumes, the ventilation isn’t good enough.
Smoking and Secondhand Smoke
Smoking during pregnancy restricts oxygen delivery to the baby and is directly linked to low birth weight, preterm birth, placental problems, and an increased risk of sudden infant death syndrome (SIDS). Secondhand smoke carries many of the same risks. This includes e-cigarettes and vaping, which deliver nicotine along with other chemicals whose effects on fetal development are still being studied. If you smoke, pregnancy is one of the strongest reasons to quit, and your provider can help with safe cessation strategies.