By Adaira Landry,Contributor,MD MEd
Copyright forbes
A box of Tylenol
Getty Images
Yesterday, President Trump told the American public that Tylenol use during pregnancy causes autism, a claim that contradicts established science. This morning, I asked a community of women physician experts for their reflections on this announcement. Shortly after, I received over 100 responses. Their reflections highlight a serious concern: when political leaders promote medical conclusions that deviate from those of frontline clinicians and governing health organizations, such as American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, the public is left navigating uncertainty, skepticism, and potential harm.
Here is a selection of expert opinions from board certified physicians, arranged by theme.
Misunderstanding the Increase in Diagnosis of Autism
A common assumption is that the rise in autism diagnoses reflects a true increase in incidence, when in fact it is more likely explained by improved physician training, broader diagnostic criteria, and greater awareness.
“The increase in autism diagnoses is in part due to the increased understanding we have of level one autism. Physician training is improving. Child and adolescent psychiatrists and pediatricians used to be the only physicians trained in diagnosing and treating autism. Now our programs acknowledge that these kids grow up, so adult psychiatry and other disciplines have had to catch up to our pediatric colleagues,” says Dr. Nicole Pavlatos-Delavoye, psychiatrist.
Erosion of Physician–Patient Trust
Safe and effective care depends on trust within the physician-patient relationship. The entire medicine system relies on patients believing that their physician prioritizes compassionate, evidence-based care.
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“As an oncologist, I witness every day how patients struggle with skepticism around treatments, like chemotherapy, which can be life-saving but is often feared for its harshness. Now, when we make people panic over something as basic and familiar as Tylenol, we risk undermining trust even further. If the public can’t rely on long-standing guidance for managing a fever or pain, how can they feel confident placing their lives in our hands?” asks Dr. Maria Borrero, medical oncologist.
“This is not the first issue or time where my medical science training may be questioned or not believed based on Party politics. These issues are eroding the physician-patient relationship. A relationship that I think is important for healing, preventive healthcare, education and public health. Healthcare decisions are open to discussion in the exam room – it would be nice if those decisions could be more science based,” says Dr. Jill Steinsiek, family physician.
The Spread of Misinformation, Disinformation and Malinformation
Misinformation is false information shared without intent to harm. Disinformation is false information shared with the intent to harm. Malinformation is true information shared out of context or exaggerated to cause harm.
“We are in an era where information is readily available to anyone, anywhere, but that doesn’t make it credible, reliable, accurate. I know there has been so much misinformation, but worse is disinformation and malinformation. It’s a very confusing time for patients, and a devastating time for physicians. Unfortunately we are currently in an environment of intentional chaos, noise, and distrust that has been intentionally created to cause doubt,” added Dr. Dena Hubbard, pediatrician/neonatologist.
Dr. Shika Jain speaking onstage
Dr. Shika Jain
“The spread of misinformation and disinformation from politicians is not accidental—it’s strategic. In a climate where fear and outrage drive attention, misleading narratives can be powerful tools to mobilize supporters, distract from failures, or undermine trust in institutions. It’s happening because misinformation spreads faster than facts, and correcting it rarely gets the same traction. When leaders amplify falsehoods, it corrodes public trust in science, medicine, and democracy itself, making it harder to reach consensus on solutions to pressing issues. Misinformation and disinformation from political leaders often reflect a calculated strategy to consolidate power, sow division, or shift focus away from systemic problems,” says Dr. Shika Jain, medical oncologist.
Oversimplifying the Causes of Autism
A major objection to the recent claim that Tylenol causes autism is that autism is known to have multiple contributing factors. Scientists have long explored the increased risk of autism based on genetic variation.
“There is no single cause of autism. There is no evidence that Tylenol nor vaccines cause autism. There is evidence that fevers in pregnancy can be harmful to the fetus,” added Dr. Chandani DeZure, neonatal and developmental medicine pediatrician.
“Correlation is not causation. Genetics and other factors must be taken into consideration,” says Dr. Robin Conwit, neurologist.
The Role of Policymakers Versus Physicians
Becoming a physician involves rigorous education and training. Developing expertise requires immense dedication and applying evidence judiciously in patient care is a complex skill. While physicians welcome thoughtful discussions with patients and policymakers, this long journey to develop expertise is why so many are unsettled when their interpretation of the literature is abruptly ignored.
“Pause, breathe, and think with your rational brain – should I listen to my pediatrician who knows my baby/child/adolescent and has studied, learned, practiced medicine or reality TV, influencers, politicians? Who has my child’s best interest at heart? Who has the most context and information about my child? What is the agenda of those essentially telling me not to trust my personal physician? When you have your next health emergency, are you going to Washington DC, White House, Congress for medical care? Or are you going to the ER?” asks Dr. Dena Hubbard, neonatologist.
“If America is the best, then why are we not listening to our best? Medicine should be practiced by physicians, scientists and others trained in data analysis and statistics, not lawyers and politicians. We need money for research and clinical trials. We need heads of NIH and CDC’s who are experts in science, medicine and data analysis, not fake emergencies and false promises,” Dr. Erica Hailey, neuroimmunologist.
Undermining Scientific Evidence and Medical Expertise
The academic research publication process is rigorous and highly selective. Studies, particularly those on controversial topics, undergo careful peer review to evaluate methodology, data quality, and interpretation. Most submissions are rejected, leaving robust and well-supported findings to be published. Misinterpreting any published research, however, increases the risk of patient harm.
“The April 2024 JAMA paper should really have put this issue to bed. Yes, it’s retrospective, but prospectively collected data and the study design is excellent. They looked at 2.5 million children over almost 30 years. Use of sibling controls entirely wiped out any association between acetaminophen and autism because autism is the result of a complex array of genetics,” says Dr. Emily Koeck, trauma/critical care surgeon.
“The body of literature, including most recent well-controlled studies, does not support a causal link between acetaminophen use in pregnancy and autism in children. The unsupported claims made by the administration yesterday create confusion and erode public trust in physicians and scientists who have dedicated their lives to the rigorous study of medical evidence and the relentless pursuit of truth. I urge every pregnant patient to rely on the expertise of qualified physicians for medical advice,” says Dr. Amelia Sutton, maternal fetal medicine & medical genetics ob/gyn.
“I am a board certified obgyn and a mother to an autistic child. Tylenol is completely safe in pregnancy and does not cause autism. Please listen to those of us that practice every single day and our specialty bodies including SMFM and ACOG. The science is there,” adds Dr. Jacqueline Mclatchy, ob/gyn.
Headshot of Dr. Onyeka Otugo
Dr. Onyeka Otugo
“It won’t change my prescribing practices for Tylenol since Tylenol is one of the only medication that women can actually take safely during pregnancy. Pregnancy is a difficult time for a lot of women and their pain and fevers should be treated. Correlation does not equal causation. I’ll discuss with my patients the recent statements, but it wouldn’t change my practices,” says Dr. Onyeka Otugo, emergency medicine.
Casting Blame on Patients
Phrases like “tough it out” place undue responsibility on pregnant patients to endure pain or fever, inadvertently stigmatizing those who take Tylenol. This framing overlooks the complex physiological and pathological processes of pregnancy.
“These types of gut reactions to poor science are steeped in misogyny. Such as Trump’s statement, ‘just let women tough it out’,” adds Dr. Ashely Renee, ob/gyn.
“This morning I’ve gotten questions like – should I tell my daughter not to take Tylenol? I took Tylenol and my child developed autism. Is this my fault? The environment this administration is creating in healthcare and public health is toxic – continuing to feed the misinformation machine. Especially as it pertains to the health of women. We deserve better,” says Dr. Jenny Flaim, radiologist.
“As a psychiatrist who sees pregnant and postpartum patients, many of whom struggle with postpartum anxiety, I can only imagine this misinformation, regarding one of the most widely used medications in pregnancy, will negatively impact mental health outcomes,” adds Dr. Kimberly Elizabeth, psychiatrist.
Overlooking the Risks of Untreated Fever
Fever caused by an infection should be addressed. There is ample evidence to the risks in both animal and human studies.
“We have plenty of data to indicate the safety of acetaminophen in pregnancy. But we also have strong data that fever in pregnancy is associated with a higher risk of autism. The 2018 Nature study is possibly the strongest evidence yet. So, [if we] don’t treat the fevers in pregnant moms the autism rate may really increase,” says Dr. Melissa Ackerman, ob/gyn.
“As a maternal fetal medicine physician who cares for pregnant individuals with high risk pregnancies, Tylenol is the safest medication and my first choice for treating fevers and aches and pains of pregnancy. Fever during pregnancy, especially in the first trimester, is associated with neural tube defects, oral clefts, and congenital heart defects. It’s also associated with fetal growth restriction and giving birth to a “small for gestational age” neonate. In labor, maternal fever can be associated with the development of hypoxic ischemic encephalopathy (HIE). Fever in pregnancy has also been linked to neurodevelopmental disorders. There are no other safe alternatives-over the counter or prescription medications – NSAIDs and opioids can cause other pregnancy/fetal complications,” adds Dr. Amanda Horton, maternal fetal medicine ob/gyn.
“While there is no proven causal link between acetaminophen use during pregnancy and autism, untreated fever and pain during pregnancy do pose significant risks to mom and baby. Untreated fever, for example, increases the risk of miscarriage, birth defects such as spina bifida, and premature birth. When individuals without medical training offer recommendations that contradict evidence-based guidance of qualified healthcare professionals and scientists, it places patients at risk and undermines the trust essential to the doctor-patient relationship,” adds Dr. Colleen W. Cardella, ob/gyn.
Recognizing the Limits of Current Research
No research study is perfect or answers every possible question. It is important to understand not only the strengths of a study but also its limitations. Recognizing these limitations helps determine how findings can be applied in the real world and guides future research aimed at addressing unresolved gaps.
Dr. Jeanne Conry
Dr. Jeanne Conry
“I am the past president of the International Federation of Gynecology and Obstetrics (FIGO) and past president of ACOG. The research on some pesticides, air pollution, phthalates is more compelling than the research referenced today. Extensive Swedish study suggests associations are related to unmeasured familial confounding factors— meaning association not causation. We recommend women use medications to treat underlying disease processes— women are not just randomly “popping pills” they are treating fevers, autoimmune disorders, surgery. It is a complex discussion — where genes and environment must be considered factors. Unfortunately the administration is not looking where the research has been very complex. It will not be a single easily identified medication. There are many layers,” says Dr. Jeanne Conry, ob/gyn.
“To my knowledge, an RCT has not been done. Medical records reviews and retrospective studies are subject to many confounders and to recall bias. It would be extraordinarily difficult to tease out an actual causative link when you take into account all of the prenatal and post birth exposures you would need to control for. Additionally, the sheer number of women who take Tylenol in pregnancy, as the only over the counter painkiller and fever reducer that is considered safe, would mean that had there been a strong causative signal, it would be very clear by now. There has not been any new science to dispute the status of the current evidence, which does not indicate a causative link. We always recommend the lowest effective dose of medication for the least amount of time possible in pregnancy as a precaution and as a way to avoid any potential complications down the line… That’s just a general principle when using any class of medication in pregnancy,” says Dr. Erin Habecker, ob/gyn and perinatal psychiatrist.
“I am all for trying to determine risk factors for autism but placing blame on a medication and the mothers who took the medication when studies of over 2.5 million children show there is no link between acetaminophen and autism is providing false blame (and likely false hope to parents seeking answers or prevention). What we do know is that there are over 100 genes that have been identified to cause autism and studies showing strong family links. I am all for searching for other causes but reinventing the wheel of things proven not to cause autism (vaccines, thimerosal, acetaminophen, etc) is not the solution,” says Dr. Erin Duchan, pediatrician.
While patient education is important to us, it is equally important to be cautious about misinformation, disinformation, and malinformation. The safest approach, when seeking more information, is to talk with your physician about what care is right for you. As shown here, the medical community is largely aligned on the safe use of Tylenol during pregnancy.
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