Is Pregnancy Safe While Taking Aspirin? Precautions You Should Take

Short answer: Low-dose aspirin (usually 81 mg daily) is commonly considered safe in pregnancy when a clinician recommends it (for example, to reduce the risk of preeclampsia). Higher doses of aspirin and other NSAIDs can carry stage‑specific risks, especially after 20 weeks and in the third trimester, so dosing and timing matter. ^[1] Higher-dose use in pregnancy is generally not recommended due to risks that vary by trimester. ^[2]

When Aspirin Can Be Appropriate

• Low-dose aspirin (81 mg): Often advised for certain conditions (such as prior preeclampsia or specific clotting disorders) and may be used throughout pregnancy under medical supervision. ^[1] Talk with your clinician about your personal risk factors and the right plan for you. ^[3]

Risks Depend on Dose and Trimester

• First trimester: Higher doses may raise the chance of miscarriage and possibly certain birth defects, so routine high-dose use is avoided. ^[2]
• Second trimester (after ~20 weeks): The FDA advises avoiding NSAIDs at 20 weeks or later because they can lower amniotic fluid, which may cause fetal problems; this warning applies to higher doses in particular. ^[4] If you are on low-dose aspirin for a medical reason, do not stop at 19 weeks without your clinician’s guidance; weigh benefits and risks with your care team. ^[5]
• Third trimester: Higher-dose aspirin raises the risk of the fetal ductus arteriosus (a heart vessel) closing too soon, and prolonged high-dose use at any point can increase the risk of bleeding in premature infants. ^[6] Monitoring may be needed if aspirin must be continued late in pregnancy for specific medical reasons. ^[5]

Practical Precautions

• Use only if clinically indicated: Take aspirin during pregnancy only if your clinician recommends it, and stick to the prescribed dose. Low-dose regimens are the typical choice when aspirin is needed. ^[1]
• Avoid higher doses unless specifically directed: High-dose aspirin for pain or inflammation is usually avoided in pregnancy because of trimester‑dependent risks. ^[2]
• Do not combine with other NSAIDs: Many over‑the‑counter pain relievers (like ibuprofen or naproxen) are NSAIDs and share similar risks after 20 weeks. ^[4]
• Report warning signs: Call your clinician if you notice unusual bleeding, severe stomach pain, persistent headaches, decreased fetal movement, or signs of low amniotic fluid (your clinician will assess via ultrasound if needed). ^[4]
• Plan around procedures: Aspirin affects platelets. Your clinician may adjust timing before certain procedures or delivery if bleeding risk is a concern. ^[2]
• Ask about start/stop timing: For preeclampsia prevention, clinicians often start low-dose aspirin in early to mid‑pregnancy and may continue until late pregnancy based on your risk profile; follow your personalized plan. ^{[1] [5]}

Pain Relief Alternatives

If you need pain relief during pregnancy, check with your clinician about safer options for your stage of pregnancy. Acetaminophen is often considered first-line, while NSAIDs (including higher-dose aspirin) are generally avoided after 20 weeks unless a clinician advises otherwise. ^[4] Discuss any over‑the‑counter product before use to avoid unintended higher-dose aspirin exposure. ^[2]

Breastfeeding Considerations

After delivery, aspirin can pass into breast milk. Safety depends on dose and the product used; low-dose may be considered in specific cases, but caution is advised and clinician guidance is important. ^[7] Product labels indicate limited information on effects in breastfed infants and milk production, so the benefits of breastfeeding must be weighed against maternal need for aspirin. ^[8] If you require antiplatelet therapy postpartum, your clinician can help choose the safest regimen for lactation. ^[9]

Key Takeaways

• Low-dose aspirin can be safe in pregnancy when prescribed for a medical reason. ^[1]
• Higher doses of aspirin are generally avoided due to risks of miscarriage (first trimester), low amniotic fluid (after 20 weeks), and fetal heart vessel issues (third trimester). ^{[2] [4] [6]}
• Always follow clinician guidance on dose and timing, and avoid self‑medicating with higher-dose aspirin or other NSAIDs. ^{[4] [5]}