President Trump told pregnant women to "tough it out" and "don't use Tylenol" during pregnancy on Monday, suggesting a link to autism despite inconclusive evidence.
Why it matters: Implying pregnant women are to blame for their child's neurodevelopmental condition — and that their pain should be tolerated — could be mentally damaging to the mom and physically harmful to the baby.
Zoom out: Autism, like other neurodevelopmental conditions, isn't caused by one thing. Instead, it involves multiple factors including genetics and environmental exposures, says American College of Obstetricians and Gynecologists representative Veronica Gillispie-Bell.
- Studies that the Department of Health and Human Services referenced as "evidence" for limiting prenatal use of acetaminophen, the active ingredient in Tylenol, because of autism risk are not conclusive.
- For example, HHS has pointed to a recent review article that suggests a link between taking acetaminophen during pregnancy and disorders including autism. However, it's based on observational data and its researchers explicitly stated that it showed association but not causation.
- Meanwhile, a 2024 study largely considered the most robust on acetaminophen use during pregnancy and autism risk — which followed more than 2 million children in Sweden — concluded that there's no connection.
State of play: Acetaminophen is widely cited by OBs as one of the best options to manage fever or treat pain in pregnancy.
- It's often taken during pregnancy instead of anti-inflammatories like ibuprofen. There's concern that the latter drugs, known as NSAIDs, could cause fetal issues related to low amniotic fluid.
- ACOG has long supported the use of acetaminophen in pregnancy as needed, in moderation, after consultation with a doctor. The organization on Monday reaffirmed its view that there's no clear evidence of a relationship between prudent use of acetaminophen and fetal developmental issues.
Reality check: Choosing to forgo acetaminophen when a mom has a fever or pain isn't a no-lose proposition. Even HHS says that "maternal fever itself carries risks, including neural tube defects and preterm birth," and acetaminophen is "the only over-the-counter medication considered safe for treating fever during pregnancy."
- "It's not just a matter of who's strong enough to resist pain," Gillispie-Bell says. "There's definitely some ill effects for not treating pain."
- Just as OBs discourage pregnant patients from going into hot tubs, they want patients to address a fever, because heat can interfere with fetal development.
- And pain, if not treated in pregnancy, can lead to elevated blood pressure and psychological concerns — which alone could be fatal.
The bottom line: Blaming the pregnant person for taking medication is not only unfair, but it's not backed by science.
Go deeper: What to know about vaccines and SSRIs in pregnancy
