Getting a tattoo or piercing during pregnancy raises many questions, both about safety and the precautions to be taken. Between risks of infection, skin reactions and potential impact on the baby, it’s essential to be well informed before making any decisions.

Definition of a tattoo

By definition, a tattoo is made by introducing ink into the skin using a tattoo machine or a device made up of tiny sharp needles attached to an electric handle. When the process is started, the needles move up and down quickly, piercing the skin superficially (1-4 mm), which allows for the injection of colourants between the epidermis and dermis. The insertion depth is likely to lead to infection or the transmission of bacterial or viral infections (ex.: hepatitis B, C and HIV). When choosing a tattoo artist, it is essential to consider health standards, the quality of natural products used and how rigorous they are in executing the procedure.

Surprisingly, there is little bleeding during the procedure. Sometimes tiny drops of blood may appear during or after – something like a scratch – but most of the time nothing.

Health risks associated with tattooing:

• The authorities responsible for monitoring hazardous health products (Food and Drug Administration in the U.S. and Health Canada here) don’t set standards for the inks and pigments used in tattoos, since they are considered aesthetic and not medical.
• There are therefore no standards to be met, which means we can never know the exact composition of the inks. The only two absolute contraindications to tattooing described in the literature are pregnancy and breast-feeding.
• Most inks used for tattooing contain chemicals and/or heavy metals that can be potentially toxic for the baby. They should therefore be avoided.
• There are no controls on the inks used and sold. Nor are there any standards to be met, since these products are not considered to be medicines. So we never know exactly what they contain.
• There is always a risk of infection when the skin barrier is broken. Approximately 1-5% of tattoo patients develop a bacterial superinfection, usually caused by normal skin bacteria. Every small perforation is likely to lead to infection, or even the transmission of bacterial or viral diseases (e.g. hepatitis B, hepatitis C, HIV, etc.). Respect for hygiene rules, the quality of the natural products used and rigor in the execution technique are therefore essential when choosing a tattoo artist.

Without a doubt, it is better to use black coloured ink that is 100% natural due to the composition, as industrial pigments, still used by some tattoo artists, can contain metals that are harmful to health. These chemical products, such as aluminium, barium, iron, mercury, lead, copper, arsenic, cobalt, nickel and selenium, which will be gradually absorbed by the body, can cause some cancers, illnesses and skin problems, including eczema, urticaria and allergies. Even temporary tattoos can contain these components!

Risks of tattooing for pregnant women

Tattoos should be avoided throughout pregnancy and breastfeeding. At present, there is no literature demonstrating additional risks to the baby in women who have had tattoos before pregnancy. On the other hand, there is a great lack of data concerning pregnant or breast-feeding women and tattoos. Several studies are therefore needed to establish specific guidelines for practice.

Here are some reasons to avoid tattoos during pregnancy:

• The woman can have vertigo and fainting spells associated with lower blood pressure
• Pregnancy hormones change the skin’s texture, and it may react differently to specific products and predispose it to allergies
• A pregnant woman’s skin is more fragile, and the insertion of needles can lead to infections (entry point for different microbes)
• A pregnant woman’s immune system is weaker at certain times during pregnancy, which increases the risk of infection and affecting the baby
• Since pregnant women have lower blood pressure, they are more at risk of hypotension if they hold the same position for a long time, which can lead to fainting
• Getting a tattoo is a stress for the body and pain which can provoke contractions and premature labour
• Even if the impact of the chemical colourants is not well known, we suspect that there are negative impacts for the future mother – and baby – when the body absorbs the metals
• A pregnant woman gains weight over nine months, which can cause the appearance of stretch marks and naturally stretch the skin. This can distort or modify the appearance of tattoos already present. Progesterone, a pregnancy hormone, helps maintain the elasticity of the skin, and tattoos around the belly button, on the calves, buttocks and thighs will stretch as the pregnancy progresses
• No information leads us to believe that there is a risk when a pregnant or breastfeeding woman gets tattooed with 100% natural products. But you need to be aware of the lack of data, and you should wait until you have weaned your baby before getting one. There is always a risk of infection, and it takes time for a woman to regain her pre-pregnancy weight (distended skin)
• There are no controls for inks that are used and sold, and there are no standards as these products are not considered a medication. So we don’t really know what they contain. So always be careful and avoid taking risks.
• You should not have a tattoo removed during pregnancy and while breastfeeding.

Epidurals and Tattoos

Many pregnant women who have a tattoo on their lower back worry or have questions about their ability to have an epidural during labour and childbirth. Given that many aspects remain unknown, some anesthetists are hesitant about doing the procedure if the tattoo is large and it covers the normal insertion sites (there are several insertion spots). However, usually a tattoo will not inhibit an epidural; the anesthetist will avoid pigmented zones (healthy ink-free skin) or modify their angle of approach (safe zones) because there is a potential risk that the product (tiny pigment particle) enters via the perforation made by the specialist and enters the spinal fluid, which can lead to severe infections and back pain. Dr. Mior, an anesthetist, told me that we don’t have data about the innocuousness of inks used in tattoos and, in addition to infection risks, there may be possible toxicity and potential inflammatory reactions. In very rare cases, the anesthetist may prefer to remove a small piece of skin at the puncture site to remove the ink before performing the epidural procedure.

In the case of a caesarean section, doctors will perform the surgery even if there is a tattoo present on the site due to avoid possible post-op complications (choosing the lesser evil).

Piercings and Pregnancy

Piercings fall under the same category as tattoos and should be avoided during pregnancy. If you already have a pierced belly button, nipple or vulva, you should remove them by the second trimester to prevent discomfort, pain, redness, itchiness or allergies due to skin changes as the pregnancy progresses.

In short, although tattooing and piercing are forms of personal expression, pregnancy is a time to be cautious. Between the risks of infection, body changes and recommendations, it’s often best to wait until after childbirth to safely modify your body. If you still feel the urge after pregnancy, we strongly encourage you to choose a caring, experienced tattoo artist who uses 100% natural products.

Marie Fortier
The Baby Expert

Updated article : February, 2025.