On Monday, former President Donald Trump announced that pregnant women should avoid paracetamol, also known as acetaminophen or the brand name Tylenol in the United States, due to an unsubstantiated link to childhood autism. Accompanied by Robert F. Kennedy Jr. and Dr. Mehmet Oz, the former talk show host and head of the Centers for Medicare and Medicaid Services, Trump’s remarks have ignited concern among healthcare professionals about the implications of this guidance.
The announcement highlights a significant issue in maternal healthcare: pregnant women often encounter inadequate and sometimes misleading medical information. Trump’s statement raises fears based on shaky research that has not been accepted by the scientific community. The focus on women’s choices as the root cause of childhood outcomes is particularly problematic. Trump suggested that women should only use medication if they are unable to “tough it out,” framing their needs against the well-being of their babies, which can create unnecessary anxiety for expectant mothers.
Research consistently shows there is no credible evidence linking paracetamol use during pregnancy to autism. A comprehensive study conducted in 2024 analyzed data from 2.5 million women who gave birth in Sweden and found no correlation between paracetamol consumption during pregnancy and an increased risk of neurodiversity in children. This study accounted for various factors, including maternal health, family history, and indications for medication use, reinforcing the absence of a link between paracetamol and autism.
Despite the absence of supporting evidence, Trump’s announcement could burden women with unfounded fears regarding their choices during pregnancy. The stigma surrounding neurodiversity diagnoses may also be exacerbated, as expectant mothers may feel responsible for their child’s health outcomes based on misleading claims.
While it is crucial to examine how medications affect pregnancies, definitive answers are challenging to obtain. Well-designed research is necessary to explore the safety of medications during pregnancy, yet Trump’s announcement lacked the scientific rigor required for such a serious topic. This kind of speculation can have detrimental consequences, particularly when untreated health issues in pregnant women can harm both their health and that of their unborn children.
The “precautionary approach” is often invoked in discussions about medication safety, suggesting that avoiding any potential risk is advisable. However, this approach must be balanced. Encouraging pregnant women to avoid effective medications like paracetamol can lead to untreated health issues. For instance, untreated fever during pregnancy poses risks to fetal brain development, and women may be driven towards alternative treatments that could be far more dangerous.
Unlike paracetamol, nonsteroidal anti-inflammatory drugs such as ibuprofen are associated with significant risks, including miscarriage and fetal complications. The potential dangers of these alternatives underscore the need for evidence-based guidance regarding medication during pregnancy.
There is an urgent need to reassess how medications are tested for safety in pregnant populations. Historically, many clinical trials have not included adequate numbers of women, leaving significant gaps in understanding potential risks and benefits. The aftermath of past scandals, such as the thalidomide tragedy, highlights the necessity for more inclusive research.
In response to these challenges, Dr. Ed Mullins, an obstetrician, and I are leading a project called Message Maternity. This initiative aims to connect healthcare researchers, funding bodies, regulatory agencies, and women themselves to address the systemic exclusion of pregnant women from clinical studies. By fostering an inclusive research environment, we can enhance patient autonomy and informed decision-making, ultimately reducing the risk of harm caused by misleading medical advice.
The controversy surrounding Trump’s remarks serves as a reminder of the need for high-quality, evidence-based research in maternal health. As the public discourse continues, it is essential to advocate for robust scientific evidence that considers the unique circumstances of pregnant women. This politically charged statement could potentially set back efforts to improve medical guidance for expectant mothers, emphasizing the importance of accurate information in promoting their health and that of their children.
