Is it okay to use acetaminophen when pregnant?

Should You Take Tylenol While Pregnant? Sorting Through the Research and Taking Sensible Steps

For years, medications containing acetaminophen (like the popular pain reliever Tylenol) were widely considered a safe harbor for pregnant people. Since other go-to fever reducers and pain relievers often aren't recommended, it’s no wonder that a significant number of women—up to 65% in the U.S.—report taking it at some point during their pregnancy. Acetaminophen is in tons of over-the-counter products, from cold and flu remedies to simple pain pills.

But the discussion got a lot more complicated a few years ago.

The Emerging Concerns: 

In 2021, a group of doctors and scientists released a consensus statement about acetaminophen use in pregnancy. Their concern? Evidence suggesting it could interfere with fetal development. They pointed to potential lingering effects on the brain, reproductive and urinary systems, and genital development.

Why might this happen? One theory is that acetaminophen acts as an endocrine disruptor—meaning it can mess with the chemicals and hormones essential for healthy growth.

Some research, particularly studies looking at high or frequent doses, has tentatively linked exposure to issues like

• Earlier puberty in girls.
• Male fertility issues (low sperm count).
• Certain birth defects in boys, like undescended testicles or hypospadias (where the urethral opening isn't at the tip of the penis).
• Potential links to attention deficit disorder and lower IQ.

Acetaminophen and Autism: A Confusing Connection

The issue got high-profile attention in September 2025 following a press conference led by President Trump, highlighting concerns that acetaminophen might be linked to autism. Some studies do show a correlation between its use during pregnancy and autism—a finding emphasized in an August 2025 review of prior research.

But here’s the crucial takeaway:

These concerns come primarily from observational studies (studies that watch people over time), which simply cannot prove that acetaminophen causes these problems.

• The Confounding Factor: Think about why a pregnant person takes acetaminophen in the first place—often, it’s for a high fever or a bad illness. The fever or the underlying illness itself could be the trigger for a negative outcome, not the medication. This is called confounding, and it's a huge problem in this type of research.

• The Counter-Evidence: In fact, a recent, very large study involving nearly 2.5 million children in Sweden found no connection between acetaminophen use and autism, concluding that the earlier reported links were likely due to confounding factors.

After the press conference, the FDA stepped in, appropriately stressing in a news release and a letter to physicians that "a causal relationship has not been established" between acetaminophen and autism and that the studies are inconclusive.

The Bottom Line: Don't Panic, But Be Thoughtful

If you took acetaminophen during a current or previous pregnancy, please don't panic. The chances are very good that your baby has not and will not suffer any ill effects. We need much more definitive research.

Currently, the scientific consensus among experts is that the available data does not warrant a prohibition of its use during pregnancy. In fact, there are risks to not taking it. For example, a prolonged, high fever may increase the risk of miscarriage or birth defects.

That's why organizations like the American College of Obstetricians and Gynecologists (ACOG) continue to consider acetaminophen acceptably safe and recommend it during pregnancy if needed.

My Sensible Steps for Pregnant People

Until we know more, here are three common-sense steps to protect yourself and your baby:

Avoid it When Possible: Treat acetaminophen use during pregnancy like any other medication—it should be limited to situations where you truly need it. Can you manage the discomfort with rest, cool compresses, or other non-medicinal remedies?

Consult Your Doctor: Always run its use by your doctor, especially if you anticipate taking it for more than a day or two. They may agree it’s the best option or suggest a different alternative tailored to your specific situation.

Minimize Use: If you do need to take it, follow the standard best practices for all medications in pregnancy: take it for the shortest amount of time possible and at the lowest effective dose to reduce fetal exposure.

When certain experts review a drug and find it linked to a particular illness, it is always best to avoid that drug as much as possible and to consult with a doctor. Medicine has become more than just caring for people; for some, it is also a business, so exercise caution.