Does this mean you have to say goodbye to everything you love when your pregnancy test comes up positive? No, but you will have to make some changes. Here’s a comprehensive guide to everything you should avoid during pregnancy (and things you can do instead, too).
Food and Drink
Your baby basically eats what you eat, so it’s important to maintain a well-balanced diet during pregnancy to ensure they are getting all the nutrients they need to grow. Beyond simply eating healthfully, there are a few foods and drinks that should be avoided.
Alcohol: High Risk
Drinking during pregnancy has been associated with negative outcomes during pregnancy and after birth like low birth weight, premature delivery, and learning disabilities. Even though more severe side effects are typically caused by heavy drinking (i.e., several drinks per day), there currently is no confirmed “safe” amount of alcohol to consume during pregnancy, says Jasmine Johnson, MD, a specialist in maternal-fetal medicine. Make non-alcoholic beverage swaps for now, like toasting with sparkling cider instead of champagne.
Fish High in Mercury: High Risk
Too much mercury during pregnancy can damage your baby’s vision and hearing, so it’s important to limit your exposure to fish containing high levels of mercury during pregnancy. As a general rule, the larger a fish is, the more likely it is to eat other fish for food—which increases the amount of mercury it contains. Avoid fish like swordfish, tilefish, and king mackerel, sticking to smaller fish like cod, tilapia, shrimp, and salmon. Canned tuna is OK in moderation, but try to choose the chunk light variety instead of solid albacore whenever possible.
Unpasteurized Foods: High Risk
It’s wise during pregnancy to avoid any dairy products, including milk, eggs, and cheeses, that are unpasteurized. The pasteurization process kills harmful bacteria that can cause illness in people with vulnerable immune systems like pregnant women. Always choose pasteurized products during pregnancy.
Raw Seafood and Eggs: High Risk
Raw seafood or sushi containing raw fish is dangerous to eat during pregnancy—it could be contaminated with all kinds of bacteria and parasites liable to make you severely ill during pregnancy. The same goes for raw or undercooked eggs. Make sure all dishes containing seafood and eggs are fully-cooked, and opt for the California roll or a veggie roll at your favorite sushi place instead of the sashimi.
Raw Sprouts: High Risk
Raw alfalfa, clover, and mung bean sprouts are breeding grounds for bacteria like E.coli and listeria, so the rule here is the same as it is for deli meat and soft cheese. If you can’t cook your sprouts thoroughly, avoid them for now.
Caffeine: Medium Risk
Moderate amounts of caffeine during pregnancy are considered OK, but it does pass through the placenta. Some studies suggest that high amounts of caffeine can cause miscarriage, though the American College of Obstetricians and Gynecologists (ACOG) says that hasn’t been confirmed. “The most recent study cannot prove that the miscarriages were related to caffeine consumption versus an abnormal pregnancy to begin with (which is the most frequent cause of miscarriage),” explains Dr. Johnson. To play it safe, make sure you don’t cumulatively get more than 200 milligrams of caffeine per day. Switch over to naturally caffeine-free beverages like herbal tea, milk, and water once you hit your daily limit.
Deli Meat: Medium Risk
Cold meats, whether from the deli counter or the container of leftovers in your fridge, can cause listeriosis. It’s rare, but during pregnancy your turkey sandwich could make you pretty sick (and, sadly, listeriosis is one of the few infections that can cross the placenta—so your baby could become very sick as well). Either skip the cold cuts or warm them up in the microwave first. If you heat them until they’re 165 degrees, they’re safe to eat.
Undercooked Meat: Medium Risk
You can still chow down on burgers and chicken wings while pregnant, but they should be well-cooked to kill any bacteria that might be living on the raw meat. It wouldn’t make your baby sick, but a salmonella infection during pregnancy could be really nasty for you. Pork and poultry should be cooked to 165 degrees and you should order those steaks and burgers done medium well, at least.
Soft Cheese: Medium Risk
Pregnant women are advised to avoid eating soft cheeses like Brie and Camembert unless they’ve been cooked in a casserole or other dish to eliminate any risk of listeria. Avoid these cheeses or choose options that have been pasteurized.
Medication
Medications and supplements, both prescribed and over-the-counter (OTC), encompass one of the largest categories of things to avoid during pregnancy. Because your baby shares your blood supply, drugs that are passed through your bloodstream can cross your placenta and have detrimental effects on your baby’s health. No drug is 100% safe to take during pregnancy, but some are necessary—and safer than others.
Prescription Acne Medications: High Risk
Prescription acne treatments like isotretinoin and spironolactone have been linked to serious birth defects, so if you’re taking them when you become pregnant you should stop immediately. Talk to your OB-GYN or dermatologist about how best to control your acne during pregnancy.
NSAID Pain Relievers: High Risk
The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen have been well-studied and these drugs pose a risk to your baby in the form of birth defects and damage to internal organs—but the risk is highest in the first trimester. “After that, it may be okay to take NSAIDs for a short period of time, up to 32 weeks,” says Dr. Johnson. “However, you should consult with your doctor.” Instead of NSAIDs, acetaminophen (Tylenol) is the recommended painkiller for pregnant women, since it’s associated with fewer negative outcomes.
Common OTC Drugs: Medium Risk
Many OTC drugs are safe to use during pregnancy, but just as many aren’t. Antidiarrheals, decongestants, antihistamines, nasal sprays, and expectorants, for example, can come with some possible risks. Always check with your doctor before taking any OTC drug during pregnancy.
Antidepressants and Anti-Anxiety Medications: Risk Dependent
You don’t have to trade your baby’s physical health for your mental health. Some antidepressants carry a low enough risk that it’s worth continuing to take them, especially if not taking them could pose a bigger health risk to you or your baby. However, some drugs have been linked to possible adverse effects on the fetus and should be avoided or swapped out for a less problematic drug. Never stop any drug, including antidepressants, cold turkey just because you get a positive pregnancy test. “If a woman has a concern about a particular medication, she should discuss a plan for stopping it safely with her doctor before she discontinues the medication,” advises Dr. Johnson.
Antibiotics: Risk Dependent
Just like antidepressants, all antibiotics carry some risks, though some are more likely to result in malformations or defects than others. Generally, the tetracycline class of antibiotics should be avoided, while antibiotics like penicillin and erythromycin are usually considered safe enough to take (especially if they’ll be treating an infection that could also pose a health risk to your baby).
Beauty
Maybe pregnancy has given you glowing skin and luscious locks—or maybe it’s left you looking like a wet cat. Want to get a mani/pedi? That’s fine, but some other treatments aren’t. You can and should take a prenatal vitamin, which will be full of many of the most essential nutrients you need but may not already be getting in your diet. If you’re still worried about a deficiency, try to get as many vitamins and minerals from real food sources as possible (so eat lots of oranges and broccoli rather than popping a vitamin C supplement).
Botox Injections and Chemical Peels: High Risk
When you use Botox for cosmetic or medical reasons, you’re essentially injecting a toxin into your bloodstream. And chemical peels literally involve applying chemical exfoliants directly to your skin. Since you should avoid exposure to unnecessary chemicals and toxins during pregnancy, these procedures should wait until after birth.
Beauty Treatments Involving High Heat: High Risk
During pregnancy, you can overheat very easily. If your core body temperature goes high enough for long enough, it can cause birth defects. Avoid any beauty treatments that require you to be exposed to high or concentrated levels of heat, including tanning salons, hot stone treatments, body wraps, and saunas or steam rooms. If you can’t go without a glow, use a bronzer or tanning cream.
Skin Care Products Containing Retinoids, Formaldehyde, and Hydroquinone: Medium Risk
We don’t have a ton of evidence proving retinoids, formaldehyde, and hydroquinone are dangerous to a fetus, but experts suspect most products containing them do pose a risk. If you’ve been a regular user of a product containing one of these ingredients and are struggling to find a safe substitute, talk to your doctor—they can work with you to find an alternative.
Piercings or Tattoos: Medium Risk
Your risk of any kind of infection is higher during pregnancy, so even if your favorite tattoo parlor follows stringent hygiene practices, a “safe” piercing or tattoo could result in a serious infection. Hold off on these until after the baby comes.
Teeth Whitening: Medium Risk
Whitening products haven’t been evaluated for safety during pregnancy, so most dentists suggest you avoid at-home or professional treatments. You can usually brush with a whitening toothpaste, though, as well as stick to the American Dental Association’s list of best practices for healthy, white teeth.
Physical Activity
With approval from your doctor, you can maintain a safe exercise routine during pregnancy. But some activities should be put on hold until after baby arrives.
Injury-Prone Activities: High Risk
If you could fall during a sporting activity (such as horseback riding, skiing or snowboarding, ice skating) or could potentially be hit in the abdomen by a projectile (think soccer, baseball, or tennis), you should avoid it. Although your baby is well protected in your uterus, severe injuries to the abdomen can cause placental abruption. Stick to low-impact activities like swimming, running on the treadmill, and taking spin classes.
Hot Yoga: High Risk
Yoga is a great, low-impact way to keep yourself fit and flexible during pregnancy, but hot yoga—with its high temps and strenuous workout—could cause severe dehydration and a dangerous elevation to your core body temp. Traditional or prenatal yoga classes are a safer choice.
Mountain Climbing: Medium Risk
There’s the fall risk, but also the altitude sickness risk. Exposure to high altitudes during pregnancy can affect your baby’s oxygenation, especially if you’re not acclimated to them. If you like the activity, you can try indoor rock climbing—not all centers will let you participate when pregnant, but it’s not automatically dangerous to do so as long as you’re experienced and your doctor has approved it.
Scuba Diving: Medium Risk
Similar to mountain climbing, scuba diving increases your chances of exposure to hyperbaric oxygen, which may have an effect on your baby’s development. Snorkeling and swimming, however, are perfectly safe!
Weightlifting: Medium Risk
There’s not a huge risk to your baby with lifting weights, but there is one for you. Pregnancy hormones loosen and relax your joints and ligaments, which makes you much more prone to injury. You can do a basic arm workout with light weights, but it’s best to skip any extreme weightlifting exercises unless you’re a practiced athlete with approval from your doctor.
Lifestyle Activities
Many aspects of your life will change during pregnancy. You’ll be able to hang onto most of your favorite hobbies, habits, and day-to-day activities, but some of them aren’t safe to do with a baby on board.
Smoking and Recreational Drug Use: High Risk
These activities have been associated with higher rates of fetal organ damage, sudden infant death syndrome (SIDS), premature delivery, and childhood asthma, among other negative outcomes. If you haven’t already stopped doing them, you should quit ASAP.
Hot Tubs: High Risk
It’s important to avoid anything that can cause extreme overheating during pregnancy, including hot tubs, to reduce your risk of birth defects and miscarriage. Stick to the pool instead!
Roller Coasters: Medium Risk
Jostling, bumping, bouncing, inverting upside down—roller coasters are fun, but they’re generally not safe for pregnant women because of their jerky movements, high speeds, pressure changes, and potential impact to your abdomen. There aren’t any official studies on this, but it’s a common-sense precaution many experts recommend. Hang out around the carnival games or arcade and save the roller coaster for after birth.
Heavy Lifting: Medium Risk
Just like weightlifting, strenuous activity during pregnancy can lead to injury more easily because of the changes to your body. Ask for help lifting and moving heavy objects—and if you absolutely have to lift something, make sure you stretch beforehand and lift with your legs, not your back.
Environmental Exposures: Medium Risk
We all come into contact with environmental toxins every day, but you have to be extra careful during pregnancy. It’s best to avoid unnecessary X-rays and exposure to lead, mercury, and pesticides, all of which may be associated with birth defects and miscarriage. If you have an outdoor cat or do a lot of gardening, take proper precautions to avoid toxoplasmosis: wear gloves while changing your cat’s litter and gardening or be sure to wash your hands thoroughly after these activities.
Stress: Low Risk
In the short-term, stress won’t cause major damage to you or your baby, but the cumulative effects of stress over time can cause high blood pressure, weight gain, insomnia, anxiety, depression, and other chronic conditions. It’s important to take care of your physical and mental health during pregnancy, so be sure to take time to relax and manage your stress levels.