Tylenol and pregnancy: Why Trump's "tough it out" can be harmful

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 neurological 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 neurodiversities, 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

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