President Donald Trump’s warning to pregnant women to stop taking Tylenol based on a largely unproven link to autism sent ripples through communities of expectant mothers, parents of autistic children, and obstetricians and midwives after decades of relying on the routine medicine.
Some parents of autistic children said they felt validated in their suspicions that outside forces contributed to their child’s condition. Other women questioned their decision to take a medication they had been assured was safe to use while pregnant. After the president told pregnant women to “tough it out” when sick, some saw an example of men faulting women for decisions they make to try to keep themselves and their children healthy.
Major medical societies stood by their positions that it’s premature to link acetaminophen, Tylenol’s active ingredient, to autism and that the medication is safe to use in consultation with healthcare providers.
“Normally I would take stronger medication, but Tylenol was the only safe thing to take during pregnancy,” said Pamela Matthews, whose 29-year-old son is autistic. She took Tylenol during her pregnancy when she had an abscessed tooth, and she said she found Trump’s comments “deeply hurtful and offensive.”
“It’s saying it’s the women’s fault and responsibility to prevent it, while men are completely absolved,” said Matthews, 64, of Alexandria, Virginia.
But Karmella Lee, a retired 65-year-old neonatal intensive care nurse in New Jersey with a 21-year-old autistic son, said she’s grateful that the president “is exploring what autism is about.” She said she took Tylenol throughout her pregnancy because of chronic back pain. While she does not know if it causes autism, she said, she believes there’s enough suspicion to warrant further study.
“There needs to be more testing to determine the causes of autism,” she said.
Two years ago, Lee was invited to join a class-action lawsuit against the maker of Tylenol that sought to add warning labels cautioning against use during pregnancy because of a potential link to autism. The suit was dismissed.
While the White House presented its announcement about possible connections between acetaminophen and autism as a groundbreaking revelation, clinicians who care for pregnant patients are treating the news with skepticism, saying it’s too hasty to deprive them of one of their only options for pain relief.
Trump and his top health officials offered competing messages Tuesday, with the president saying nearly a dozen times during a rambling hourlong news conference, “Don’t take Tylenol!” Meanwhile, the Food and Drug Administration offered more measured guidance: Proceed with caution and use the medication only if feverish — advice already routinely provided to pregnant patients.
After the White House news conference, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine reaffirmed their guidelines identifying acetaminophen as safe to use for pain relief in consultation with healthcare providers.
In a statement, ACOG President Steven J. Fleischman said the federal comments about the medicine and autism were based on faulty science and were “irresponsible” because of “the harmful and confusing message they send to pregnant patients.”
Trump dismissed the ACOG on Monday as an “establishment” organization “funded by a lot of different groups.”
Part of the reason the federal warning has received a cautious reception from health providers is that it’s not based on new science. Federal health officials have been studying previous research — including an August review by Mount Sinai and Harvard researchers — that suggests there could be an increased risk of autism in children when acetaminophen is used early in pregnancy.
“This is data that’s been out for a while,” said Jeffrey Chapa, a maternal-fetal medicine specialist based in Ohio and the national medical director at Obtelecare, which provides telemedicine obstetrics care across the United States. “Could there be an association? Sure. Is it causative? I don’t think so based on the evidence we have to this point.”
The conversation about acetaminophen and autism is one Chapa has had with patients when previous research has been released, including a 2024 study that looked at 2.5 million children in Sweden and found no association. But news of the White House’s plans to link the two hadn’t registered with the 20 patients he’d seen by Monday at 3:15 p.m. None brought it up, he said. One did the day after the announcement.
Research has more conclusively shown that “untreated high fever and severe pain in pregnancy can carry risks for both the parent and the baby,” Nikia Grayson, a certified nurse midwife and chief clinical officer at Choices Center for Reproductive Health in Memphis, said in an email. “So, it’s always about balancing benefits and potential risks.”
Sarah Weller, who is expecting her first child at the end of October, said she has friends with autism and friends whose children have autism, and she doesn’t consider the condition “scary.” Weller, who is 40 and lives in Schenectady, N.Y., looked into Tylenol early in her pregnancy and concluded that there was no link to autism and that it was more important to take the medication to stay healthy.
“I worry that women will not do what they need to during pregnancy,” she said. “And that parents of autistic children will be blamed for something they did.”
Health and Human Services Secretary Robert F. Kennedy Jr. nodded Monday to the FDA’s recognition that acetaminophen “is often the only tool for fevers and pain in pregnancy, as other alternatives have well-documented adverse effects.” Kennedy suggested that clinicians exercise “their best judgment” by prescribing “the lowest effective dose for the shortest necessary duration, and only when treatment is required.”
Nonsteroidal anti-inflammatory medications such as Advil and Aleve are not recommended for pregnant patients because they can harm the fetus, with the FDA warning that they can cause kidney problems and lead to low levels of amniotic fluid.
Cynthia Gyamfi-Bannerman, chair and professor of obstetrics, gynecology and reproductive sciences at the University of California San Diego School of Medicine, as well as a past president of the Society for Maternal-Fetal Medicine, said Tylenol is sometimes used when a pregnant patient with high blood pressure has a severe headache and doctors want to rule out conditions such as preeclampsia, a potentially dangerous complication. Giving acetaminophen can help determine whether the pain stems from high blood pressure or a more benign cause, she said.
During the White House news conference, the president told pregnant women to endure discomfort and avoid taking Tylenol, even if they have to “fight like hell.” Veronica Gillispie-Bell, a practicing obstetrician and vice chair of the ACOG’s Clinical Practice Guidelines Committee-Obstetrics, said that Trump’s admonition had “such a negative connotation” and that many of his statements were “just really offensive to women.”
Some doctors and midwives said that until medical society guidelines change, the practice of telling pregnant patients to treat fevers, aches, and pains with acetaminophen won’t change, either.
“Until we get to that point, we aren’t going to say anything different,” said Jennie Joseph, a certified midwife and founder and president of Commonsense Childbirth, a birthing center and midwifery school in central Florida dedicated to eradicating racial disparities in perinatal care.
“Our mamas and the families we serve are already faced with all these things that cause harm all day long,” she said.
Eliminating acetaminophen from their treatment protocol without sound guidance from doctors groups or from “somebody else who has some clue and some science,” she said, could lead to more harm.