| Air travel | Air travel generally is safe for pregnant women until four weeks before the expected date of delivery.17 | C | Consider the availability of medical resources at the destination. |
| Lengthy trips are associated with increased risk of venous thrombosis.2 | C | Detailed information is available online athttp://www.cdc.gov/travel/pregnant.htm. |
| Breastfeeding | Breastfeeding is the best feeding method for most infants. Breastfeeding contraindications include maternal HIV infection, chemical dependency, and use of certain medications.18 | B | It is not known how advice from caregivers to new or expectant mothers affects breastfeeding success.18 |
| Structured behavior counseling and breastfeeding-education programs may increase breastfeeding success.18,19 | B | |
| Exercise | Pregnant women should avoid activities that put them at risk for falls or abdominal injuries.20 | C | At least 30 minutes of moderate exercise on most days of the week is a reasonable activity level for most pregnant women.20 |
| Scuba diving during pregnancy is not recommended.20 | C | |
| Hair treatments | Although hair dyes and treatments have not been associated clearly with fetal malformation, exposure to these treatments should be avoided during early pregnancy.21 | C | —— |
| Hot tubs and saunas | Hot tubs and saunas probably should be avoided during the first trimester of pregnancy.22,23 | B | —— |
| Maternal heat exposure during early pregnancy has been associated with neural tube defects and miscariage.22,23 | B | |
| Labor and delivery | All pregnant women should be counseled about what to do when their membranes rupture, what to expect when labor begins, strategies to manage pain, and the value of labor support.1 | C | —— |
| Medications: prescription, over-the-counter, and herbal remedies | Few medications have been proven safe for use in pregnant women, particularly during the first trimester of pregnancy.2 | C | The risks associated with individual medications should be reviewed based on the patient’s needs.24 |
| Sex | Sexual intercourse during pregnancy is not associated with adverse outcomes.2 | B | —— |
| Substance use: alcohol | All pregnant women should be screened for alcohol misuse.25 | B | There is good evidence that counseling is an effective intervention in decreasing alcohol consumption in pregnant women and morbidity in their infants.26 |
| There is no known safe amount of alcohol consumption during pregnancy. Abstinence is recommended.2,25 | B | |
| Substance use: illicit drugs | All pregnant women should be informed of the potential adverse effects of drug use on the fetus.27 | C | Women who use illicit drugs often require specialized interventions, ideally within a harm-reduction framework. |
| Admission to a detoxification unit may be indicated. Methadone therapy in opiate-addicted women may be life-saving.3 | C | |
| Substance use: smoking | All pregnant women should be screened for tobacco use, and pregnancy-tailored counseling should be provided to smokers.2,28 | A | Smoking-cessation counseling and multicomponent strategies are effective in decreasing the incidence of low-birth-weight infants.2,10,26,28 |
| Workplace | Some working conditions, such as prolonged standing and exposure to certain chemicals, are associated with pregnancy complications.10 | B | Employment is associated with favorable demographic and behavioral characteristics, and generally is not associated with adverse pregnancy outcomes.10 |