Recently, Donald Trump (and others in his administration) has made public comments suggesting that paracetamol (e.g. acetaminophen or Tylenol) may not be safe during pregnancy, particularly raising the possibility of links to autism. These statements have stirred concern among expectant mothers, health professionals, and the wider public. But how well do his claims stack up against the best available scientific evidence? Below, we’ll unpack what is known, what remains uncertain, and why nearly every major health authority still regards paracetamol as the safest pain‐killer/fever‐reducer for use in pregnancy when used correctly.
What Trump Has Claimed
- That paracetamol use during pregnancy increases the risk of autism in children.
- That expecting mothers should avoid or minimise use of paracetamol in response to those risks.
These declarations mirror findings in some observational studies, but Trump’s statements tend to present the risk as more definitive than the evidence supports.
What the Evidence Actually Says
Here’s what current research and clinical guidance show:
1. Observational Associations, Not Proven Causality
- Several studies have found associations between paracetamol use during pregnancy and neurodevelopmental outcomes in offspring, such as autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD).
- However, association does not equal causation. Many of these studies are subject to confounding variables—situations where some other factor (e.g. maternal fever or infection, genetics, environmental exposures) could be responsible for both the need for paracetamol and the neurodevelopmental outcome.
- A recent large Swedish study of 2.48 million children did a sibling-control analysis, which helps reduce some kinds of confounding. It found that when comparing siblings (one exposed to paracetamol during pregnancy, the other not), there was no evidence of increased risk of autism, ADHD, or intellectual disability.
2. Expert Guidance and Position Statements
- The MHRA (Medicines & Healthcare products Regulatory Agency) states that there is no evidence that taking paracetamol during pregnancy causes autism in children and that paracetamol remains the recommended pain relief option for pregnant women when used as directed.
- The NHS guidance says that paracetamol is the first choice of painkiller if you’re pregnant. It’s commonly taken during pregnancy and does not harm your baby. They also emphasise that before taking any medicine during pregnancy, including paracetamol, you should check with your midwife, GP or pharmacist—and use the lowest dose needed for the shortest period.
3. Risks of Not Treating Fever or Pain
- High fever is known to carry its own risks, including potential fetal complications, miscarriage, or birth defects. Untreated pain can lead to stress, elevated blood pressure, poor sleep—all of which can adversely affect both mother and baby.
- Paracetamol is one of the few relatively safe options. Many other painkillers have more known risks, especially in certain trimesters.
Where Uncertainty Still Lies
However, there is some uncertainty. It’s important to acknowledge:
- Duration and dose matter. Some observational studies suggest that longer exposure or use over many days might correlate with higher risks. Short-term, low-dose use appears to carry minimal (if any) observable risk.
- Measurement issues: Many studies rely on self-reported use, which may not perfectly capture timing or dose.
- Mechanistic data is not yet conclusive. Laboratory studies suggest possible biological pathways (oxidative stress, hormone disruption, etc.), but these do not by themselves prove human harm in real-world use.
Why Paracetamol Is Still Considered the Safest Choice (When Used Properly)
Given the available data, here’s why medical authorities still recommend paracetamol:
- Relative safety: Compared to alternatives—such as some NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which are contraindicated in certain trimesters, or opioids, which carry more risks—paracetamol has fewer known harms in pregnancy when used correctly.
- Benefit vs. harm: The harms of untreated pain or fever are real. Managing these symptoms safely is part of good prenatal care. The potential risks suggested are small, uncertain, and not confirmed as causal.
- Guidelines are clear: Use the lowest effective dose, for the shortest duration necessary, and only when medically indicated.
Conclusion
Claims like those from Donald Trump about paracetamol and autism resonate because they tap into real anxieties—but they are not, at this time, supported by strong, conclusive scientific evidence. The best‐available studies do not confirm a causal link between paracetamol use in pregnancy (at appropriate doses and duration) and autism or other neurodevelopmental disorders. On the other hand, untreated fever and pain carry risks.
So, the balanced, evidence-based position remains: paracetamol is currently the safest broadly available painkiller/fever reducer during pregnancy, provided it’s used properly. As always, pregnant people should talk with their healthcare providers to make decisions based on their individual situation.
