The thread about sex reminded me of another one: It bothers me when a couple have sex which could lead to pregnancy in a situation where a pregnancy would be a disaster. I'm not saying it's not realistic -- people have been doing dangerous, short-sighted things because it seemed a good idea in the moment since the dawn of time. But when it happens in books, it tends to make me wince and get pulled out of the story. And if it happens in a romance, and all the risk is on her side (which it usually is in historical settings) it makes it harder for me to believe he actually cares about her, when he's willing to gamble with her future.
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