Heightened smell sensitivity is one of the most common early pregnancy symptoms, so it's natural to wonder whether a scent that never bothered you before is worth worrying about.
What the guidance actually says
There's no CDC, ACOG, or EPA statement that specifically prohibits car air fresheners during pregnancy. General pregnancy health guidance (e.g., the American Pregnancy Association) recommends good ventilation and minimizing exposure to strong fragrances and VOCs where possible, simply because pregnant people can be more sensitive to smells and some general research has looked at broader VOC exposure — not because air fresheners specifically have been shown to cause harm.
Our honest take
If a scent makes you nauseated or gives you a headache while pregnant, that's reason enough to remove it — trust how your body responds over any product claim (including ours). If you want to keep a light scent in the car, choosing a lower-intensity paper freshener over a strong aerosol spray, and keeping a window cracked when you first hang it, is a reasonable, low-effort way to reduce exposure.
Bottom line: there's no specific medical warning against car air fresheners in pregnancy, but "when in doubt, ventilate and go lighter on strong scents" is sound, general advice — and your own sensitivity is the best guide.
Sources: American Pregnancy Association (americanpregnancy.org); general VOC-exposure research, NIH/PMC.