As an OB-GYN who took Tylenol during pregnancy, I know acetaminophen is safe

In recent weeks, federal health authorities — and the president himself — have created confusion and fear among pregnant patients and the general public by raising unsubstantiated concerns about the use of acetaminophen, a common pain relief medicine, during pregnancy.

As an obstetrician-gynecologist (OB-GYN) — a physician trained to provide care for pregnant patients — I want to clarify that despite these warnings, acetaminophen remains safe, and it may be medically important for people to use in pregnancy.

When patients are pregnant, the same travails that everyone else experiences — including pain, headaches, and fevers — are different, and potentially more serious. For instance, fevers can be incredibly dangerous, and if they are left unaddressed, they can cause birth defects or even pregnancy loss.

Headaches can be a sign of preeclampsia, a potentially fatal condition involving high blood pressure; it is important to see if an over-the-counter medicine provides relief, which may indicate a cause other than preeclampsia. However, most pain relievers and fever reducers are not safe to use during pregnancy and carry their own risks to the fetus.

That is where acetaminophen — known by many as Tylenol — comes in. Decades of research have shown that acetaminophen does not pose a risk to the fetus, and it has been proven to be effective at managing pain and reducing fevers.

Indeed, when I was 10 weeks pregnant with my third child and was diagnosed with influenza, I took scheduled doses of acetaminophen over several days.

I knew that acetaminophen was safe, even in the first trimester. I also understood that if I did not take it to suppress my temperature, the high fever that resulted could cause a birth defect or a miscarriage. Thankfully, with the help of acetaminophen, I felt better within a few days and went on to have a healthy pregnancy, delivery, and child.

Unfortunately, in a recent announcement warning people against taking acetaminophen during pregnancy, government officials pointed to studies suggesting that acetaminophen might play a role in causing autism. What people should know is that those studies were not well-conducted, and they did not come to a firm conclusion that taking acetaminophen in pregnancy led to any childhood neurological disorders.

Disappointingly, the president and his team failed to mention that other studies — well-designed studies with large numbers of participants and strong conclusions — found that acetaminophen does not cause autism. For example, one study documented in the Journal of the American Medical Association (JAMA) looked at nearly 200,000 children born over a period of almost 25 years in Sweden, comparing pairs of siblings to facilitate the most objective and logical data analysis. It concluded outright that the use of acetaminophen in pregnancy was not associated with autism, attention-deficit/hyperactivity disorder (ADHD) or intellectual disability.

My concern as an OB-GYN is that my patients are hearing the warnings from the government and believing that, by taking acetaminophen in pregnancy, they could be doing something wrong. That could not be further from the truth.

In fact, if patients follow the government’s recommendations and avoid acetaminophen use during pregnancy — and instead try to “tough it out” and suffer through pain, headaches, and fevers without any medical intervention — they could actually expose their fetus to the harms that they are trying to avoid—and worse.

As a doctor, I have cared for countless patients throughout their pregnancies. I know that they do all that they can to have a healthy baby and to give their children a foundation for a long, happy life. That is why it is so unsettling for me to see our public health agencies — who we expect to be unbiased medical experts that review the science to make the best possible recommendations — stoking fear and exposing people to harm.