Acetaminophen remains safe and effective for treating pain and fever during pregnancy, according to an updated statement from the Society for Maternal-Fetal Medicine (SMFM) that brings clarity to months of conflicting headlines about the common painkiller. After a comprehensive review of recent scientific evidence, the SMFM found no established causal link between acetaminophen use during pregnancy and increased risk of autism spectrum disorders or attention deficit and hyperactivity disorder (ADHD) in children — a reassurance that matters deeply given that an estimated 65 percent of pregnant women take acetaminophen at some point during their pregnancy, primarily for headaches and fever.
The stakes of this guidance are significant. Untreated fever and pain during pregnancy carry their own serious health risks that many pregnant people may not fully appreciate. Untreated fever, particularly in the first trimester, is known to be linked to birth defects and miscarriage. Maternal fever during labor can also be associated with poor neonatal outcomes. "Both untreated fever and pain during pregnancy carry potential health risks, so you shouldn't just 'tough it out,'" said Judette M. Louis, MD, MPH, chair of the SMFM Publications Committee.
The SMFM's recommendation is grounded in a careful assessment of the available science. While newer studies on prenatal acetaminophen exposure and childhood neurobehavioral issues vary in their findings, the organization determined these studies have significant limitations in their design — a crucial distinction that means the evidence does not support causal claims. This distinction matters for millions of pregnant people who face real pain and fever and need reliable medical guidance, not fear-based headlines.
Acetaminophen, the active ingredient in Tylenol and many other over-the-counter and prescription medications, remains the first-line recommendation for pregnant patients seeking pain relief and fever reduction. The SMFM also encourages nonpharmacological approaches to complement medication when appropriate, including hydration and physical therapy to help manage pain during pregnancy.
The organization explicitly advises against alternatives. Nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of fetal renal impairment, premature closure of the ductus arteriosus, oligohydramnios, and maternal bleeding. Opioids, meanwhile, carry their own serious concerns: medications taken during pregnancy are associated with neonatal abstinence syndrome, addiction, and sedation, making them inappropriate as first-line pain treatments for pregnant people.
This updated statement, published in the journal Pregnancy, reflects the SMFM's commitment to synthesizing complex medical evidence and translating it into clear guidance for both healthcare providers and the millions of pregnant people who need practical answers about medication safety. In an era of fragmented health information, a clear reaffirmation from a leading medical organization offers something valuable: evidence-based reassurance grounded in science rather than speculation.