Is it safe to take Tylenol or other pain relievers while pregnant? Medical doctors weigh in.

My mom was the first person to mention to me that President Trump was expected to announce a link between acetaminophen (Tylenol) use during pregnancy and a higher incidence of autism. As a health writer and editor who is four months pregnant with my third child — and who has taken acetaminophen as needed during each of my pregnancies — my internal alarm bells went off. Not because I planned to trash every Tylenol bottle in my medicine cabinet, but because I was concerned about two things: 1) how the underlying studies spurring the announcement were being interpreted and 2) the risk of confusion or fear following such a high-profile claim. After all, if you put "autism," "pregnancy" and a common OTC pain reliever in the same sentence, the news is going to hit the headlines.

But after the president's official statement was released earlier this week, my first step wasn't to panic. It was to go to the sources and the experts. I looked up the 2025 study in question, along with additional research that puts those findings into context, plus statements from major health organizations like the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Psychiatric Association (APA). Finally, I personally interviewed several trusted medical experts for their perspectives on the subject.

The big picture: Some observational studies report associations between prenatal acetaminophen exposure and later neurodevelopmental diagnoses, but they don't show that Tylenol causes autism. Meanwhile, the ACOG says acetaminophen remains an appropriate first-line option in pregnancy when clinically indicated, used at the lowest effective dose for the shortest possible time — especially to treat fever, which itself can harm a pregnancy if left unmanaged.

That leaves more practical — and possibly more important — questions: How can pregnant patients safely manage pain or fever? When is it important not to "tough it out"? What nondrug options can help a headache or backache? Are other OTC pain relievers safe in pregnancy? And if you're now wondering whether Tylenol is "unsafe" (to be clear, that's not what the medical community is saying), how do you make the best choices for yourself and your baby with your clinician's guidance?

Here's what the experts (and the research) have to say.

Table of contents

Medications should always be taken with a doctor's guidance

One point that all the experts I spoke with emphasized is that what a pregnant person eats, drinks and takes as medication can affect the developing baby. This is why alcohol and smoking are "out" while fruits and vegetables are "in." Some medications are considered safe in pregnancy, others are definitively unsafe and some fall into a gray area where risks and benefits need to be carefully weighed.

That's why open communication with your doctor is key, whether you're considering taking an OTC drug, a prescription or even a supplement. "Following dosing guidelines and checking with your doctor before combining medications helps avoid complications or unintended risks," says Kate McLean, MD, MPH, a board-certified ob-gyn and chief medical officer at Evvy. "Every pregnancy is unique, so having medical guidance ensures that pain management is tailored safely to the individual."

OTC pain medications: What's safe during pregnancy?

"The medicines most people reach for when they have pain or fever are acetaminophen (Tylenol), ibuprofen (Advil, Motrin), aspirin, and naproxen (Aleve). But pregnancy changes the rules," says Steven Quay, MD, PhD. "The goal is not to scare pregnant women away from pain treatment but to equip them with knowledge. Uncontrolled pain has risks. Overuse of medication has risks. The safest path is balance, guided by your physician or other health care giver."

Here's what you need to know about common OTC pain relievers during pregnancy:

Acetaminophen: Generally considered safe when used correctly

"Acetaminophen is generally considered the safest first-line choice in pregnancy, especially when used at the lowest effective dose and for the shortest necessary time," says Quay. Likewise, McLean points out that, unlike some other OTC pain relievers, "It doesn't interfere with the baby's heart or kidney function and has not been proven to cause neurodevelopmental concerns in children."

But that doesn't mean you should take more than directed. "The difference between a medicine and a poison is dose," Quay says. "Even acetaminophen, which we view as safe, can cause dangerous liver damage if taken in excess. In pregnancy, overdosing or prolonged use carries risks we are still uncovering. Following your doctor's advice and the package directions isn't just legal boilerplate — it is a safety net for both you and your child. [Acetaminophen] should be used with the same respect we give to any powerful tool."

Given the limited options available to pregnant women, acetaminophen remains the best possible choice, as long as it's used as directed. McLean emphasizes, "many doctors, myself included, feel confident recommending it when needed."

Ibuprofen: Generally not safe, particularly in the third trimester

Ibuprofen, commonly sold as Advil or Motrin, is a nonsteroidal anti-inflammatory drug (NSAID). While early-pregnancy risks appear lower than taking it later in pregnancy, most doctors recommend avoiding it entirely, especially after 20 weeks. "NSAIDs can cause premature closure of a vital fetal blood vessel in the heart — the ductus arteriosus — and kidney problems in the fetus," says Quay.

While the risks are much lower, there's some evidence that NSAID use in the first and second trimesters can also cause problems. "First and second trimester use may increase risk of miscarriage or certain congenital abnormalities," McLean says. However, if you're dealing with serious pain and no alternatives are available, give your ob-gyn a call — rare exceptions may be made on a case-by-case basis.

Naproxen: Generally not safe, particularly in the third trimester

Naproxen (available as Aleve) is also an NSAID, so it has the same general safety guidelines as ibuprofen — it should generally be avoided, particularly in later pregnancy.

Aspirin: Not advised for pain relief, but may be prescribed for other purposes

Aspirin is also an NSAID, so when taken in its full-strength form (the type intended for pain relief), it's generally considered off-limits during pregnancy. That said, because of aspirin's blood-thinning capabilities, "low-dose aspirin (81 mg daily) is sometimes recommended by OBs to lower risk of preeclampsia," says McLean. However, she emphasizes that "this is very different from taking standard pain-relief doses."

Topical pain relievers (patches and creams): Unclear safety

It may seem safe to use a topical pain patch or pain relief cream when your muscle aches and pains creep in, since they're applied to your skin and not ingested. However, the active ingredients in these products work by being absorbed into your body.

While they're intended for localized relief and the ingredients shouldn't have much systemic impact, McLean says there's limited data on their safety during pregnancy, so they're generally not recommended unless approved by your doctor.

Prescription pain relief during pregnancy

Doctors generally avoid prescribing more powerful pain relievers, including opioids like oxycodone, hydrocodone, codeine and tramadol, during pregnancy due to the potential side effects and detrimental outcomes to the baby. However, this isn't a hard-and-fast rule.

"Under very specific circumstances, prescription medications can be offered under medical supervision," says Adjoa Boateng Evans, MD, MPH, a board-certified anesthesiologist and intensivist, who cites scenarios where severe, short-term pain may call for low-dose opioids where the benefits outweigh the risks.

McLean concurs but emphasizes that the risks to the unborn baby can be significant, pointing to the "potential for neonatal withdrawal syndrome, preterm birth, low birth weight, and in some studies, increased risk of congenital abnormalities." For this reason, opioid prescription during pregnancy is "dependent on the individual and is always a case-by-case medical decision," McLean says.

Why pregnant people shouldn't "tough it out" when pain or fever strikes

If recent headlines have you second-guessing that bottle of acetaminophen when back pain from a growing belly kicks in, remember this: Untreated pain itself can be harmful for both you and your baby.

"Uncontrolled pain is not benign. Severe or chronic pain in pregnancy can raise blood pressure, worsen sleep, drive up stress hormones like cortisol and increase risks of anxiety and depression. All of these can affect fetal growth and development," says Quay, who adds that a woman who is laid out by unrelieved pain likely won't be in the best physical or mental state to nourish and protect her baby. "Reliable pain relief is not a luxury, it's a part of safe prenatal care," he says.

It's also important to note that pain in pregnancy is common, though hardly welcome. Faith Ohuoba, MD, a board-certified ob-gyn, explains that normal physiological changes can trigger headaches, back pain, and round ligament pain. But when pain is severe or persistent, it can have "significant physical and psychological effects, like stress hormones, sleep deprivation, anxiety and depression," which may increase the risk of preterm birth, low birth weight or preeclampsia. These aren't concerns to ignore.

McLean adds that "having safe, evidence-based options" for pain relief is critical to "help ensure that pregnant individuals don't have to choose between protecting their baby and caring for themselves."

"Access to appropriate pain management can give mom back some control and help with overall physical and physiological changes due to pregnancy and childbirth, thereby preventing health risks to mom and baby," says Karen Ann Klawitter, MD, a board-certified pediatrician practicing telemedicine in Florida.

Does taking Tylenol during pregnancy cause autism?

In a nutshell: No, acetaminophen does not cause autism.

While current headlines may have you worried, all of the experts I spoke with were quick to squash the assertion that there's a causal link between the two.

"Currently, there is no official link between acetaminophen use and autism," says Nechama Sorscher, PhD, licensed child neuropsychologist, psychotherapist and author of Your Neurodiverse Child. "It’s important to know that there is no single cause of autism, and this new study does not conclude that acetaminophen [use during pregnancy] causes autism. Autism has a genetic component, but there are biological and environmental factors at play as well. We still have a lot to learn."

But because we do have a lot left to learn, we have to be cognizant of the current research and respectful of new findings as they arise. That means taking each new study not as confirmed evidence, but as a new piece of information that should be viewed through the lens of the full body of research. "Here's the truth: Some observational studies have shown an association [between acetaminophen use during pregnancy and autism]. But an association is not proof of cause. It may be that the women who needed acetaminophen because of an infection, inflammation or fever, already had factors that influenced brain development," says Quay. "No randomized trial — the gold standard — has tested this question, and likely never will, for ethical reasons."

Public health expert and infectious disease specialist Tyler B. Evans, MD, MPH, also cites the importance of taking medical guidance "rooted in consensus from the medical community" rather than "sweeping federal warnings." That means turning to medical bodies like ACOG, AAP and the APA to understand current standards and guidelines of care, and asking your own doctor for specific recommendations based on your medical needs and history.

"The truth is this: The science is not settled on acetaminophen and autism. There are conflicting studies, and the most rigorous research to date does not show a meaningful link — certainly not a causal one," Evans says.

Should I be worried if I've already taken Tylenol during my pregnancy?

Also, no. The experts I consulted all agree that women shouldn't worry if they've taken acetaminophen while pregnant. "Pregnant women should not be concerned with the appropriate, medically necessary use of acetaminophen when directed and monitored by a doctor. The well-known risks of not treating maternal pain [and fevers] during pregnancy far outweigh the unproven and theoretical risks associated with acetaminophen use," says Klawitter.

However, experts also say that it's important to be prudent about taking the medication. "It is smart to be cautious with acetaminophen during pregnancy, but it's just as important to make sure you're treating pain or fever, since untreated symptoms can also affect the growing baby. Pregnancy is all about balance, try to keep medications to only what's really needed, and focus on feeling your best with healthy foods, gentle activity, stress management and a positive mindset," says Sorscher.

7 medication-free options for managing mild pain at home

If you're dealing with mild pregnancy-related aches that aren't disrupting your day, medication-free strategies may be worth trying. You'll still want to check with your doctor — both to get their go-ahead and to see if they recommend pairing these approaches with acetaminophen when needed. But as Boateng Evans notes, many non-medication strategies "can be very effective for mild pain." Here are some top expert-recommended options:

1. Warm baths

While Quay emphasizes that you shouldn't crank the heat on your bath up to high temps, warm baths can do wonders for relieving aches and pains. Not to mention, lying in water can help take some of the weight off your tired joints.

2. Heating pads

Warm heating pads can help reduce pain in a number of ways. First, the heat itself can work to blunt your pain by blocking the pain receptors in the nerves at the site of the pain. Second, increased temperature of the affected tissue can help improve flexibility and range of motion, reducing the tension that can contribute to pain. Finally, the added heat helps increase blood flow to achey muscles, delivering more oxygen and key nutrients to the affected areas, encouraging healing of affected tissue.

While you shouldn't apply a heating pad directly to your belly, using one on your low back, hips or legs may be exactly what you need to find relief.

3. Proper hydration

Dehydration can lead to headaches, and pregnant women may be more susceptible to dehydration, as they need to increase their water intake to support the metabolic processes taking place while growing a baby.

If you find yourself struggling to drink the recommended 8-12 cups a day, and you're also suffering from frequent headaches, the two issues may be linked. Make sure you're carrying a water bottle with you, and ask your doctor if they suggest adding a pregnancy-friendly electrolyte mix to amp up your intake of nutrients like sodium, potassium, magnesium and calcium.

Yahoo Wellness Editor and registered dietitian Kelli McGrane says that Needed's Hydration Support is a third-party tested option specifically formulated for people who are pregnant or chestfeeding, and it doesn't contain excessive amounts of any nutrient. But she's also clear that pregnant women should check with their providers to make sure consuming extra sodium through supplements is OK — particularly if you have gestational hypertension.

4. Low-impact activity

Believe it or not, the solution to pain isn't always lying down and hoping it will go away. Low-impact exercise like walking, swimming or prenatal yoga can help prevent and reduce mild to moderate pain. In fact, one 2023 meta-analysis looking specifically at the role of physical activity during pregnancy and subsequent pain found that exercise "could effectively help to diminish pain intensity, reduce disability due to pain and generally reduce pain."

While you'll want to discuss any changes in activity with your ob-gyn, exercise during pregnancy has a long list of potential benefits for mother and baby when pursued with the approval of your medical provider.

5. Massage

Carrying extra baby weight can lead to tired, swollen feet, sore legs and an aching lower back. A gentle massage — whether from a partner or a trained prenatal massage therapist — can help ease mild discomfort. If those aren't available, a back or foot massager may offer some relief, but check with your doctor first and avoid devices that apply deep pressure directly to the abdomen.

6. Supportive pillows

There's a reason why pregnancy pillows are so popular — they really work. McLean specifically suggests them as a good pain-relief option, and I can share from my own experience that a well-placed pillow can help support your lower back, your belly and your legs, preventing some of the misalignment that can take place during sleep.

7. Mind-body practices

All of our experts mentioned relaxation techniques, meditation and breathing exercises as potential first-line options for helping reduce pain. McLean points out this is particularly true of "stress-related discomfort," as increased levels of stress are actually linked to higher levels of pain, where pain and stress become an interwoven feedback loop — the more pain you have, the more stressed you become about experiencing pain, which can further contribute to the tension and physiological responses that signal for more pain.

FAQs

Which painkillers are unsafe during pregnancy?

Most prescription painkillers are not recommended during pregnancy except during specific, medically supervised situations. For OTC painkillers, acetaminophen is the only widely available and supported painkiller that's considered generally safe at all stages of pregnancy. Other common OTC options — including aspirin, ibuprofen and naproxen — are not advised, unless under the specific guidance of your doctor.

Is it bad to take Tylenol while pregnant?

No. As long as you're taking Tylenol (acetaminophen) according to the dosage instructions and with the approval of your ob-gyn, every physician and health expert we spoke with agrees that it is safe. That said, everything a pregnant person consumes can affect the growing baby. For that reason, experts recommend using acetaminophen with prudence — at the lowest effective dose and for the shortest necessary time.

Why shouldn't I take ibuprofen while pregnant?

Ibuprofen (commonly sold as Advil or Motrin) is generally not recommended during pregnancy, especially after 20 weeks of gestation. Taking this NSAID later in pregnancy has been linked to premature closure of a vital fetal blood vessel in the heart (the ductus arteriosus) and potential kidney problems in the fetus.

The takeaway

Pain is common in pregnancy, and medical experts agree that safe, reliable relief is essential for the health of both mother and baby. Right now, acetaminophen is the main OTC option that meets those criteria. Trying to "tough out" pain is discouraged, since unmanaged pain can create additional health risks.

Still, medication decisions should always be made with your ob-gyn, since no two pregnancies are alike. "Remember that successful pain management begins with communication," says Ohuoba. McLean adds, "It's normal to need support along the way. The most important thing is to never suffer in silence or dismiss your own discomfort — talk to your provider about what you're experiencing. There are safe, effective ways to manage pain, and your health and comfort matter just as much as your baby's."

Meet our experts

• Kate McLean, MD, MPH, a board-certified ob-gyn and chief medical officer at Evvy

• Steven Quay, MD, PhD and the founder of Atossa Therapeutics

• Faith Ohuoba, MD, board-certified ob-gyn and founder of Myoimani

• Adjoa Boateng Evans, MD, MPH, a board-certified anesthesiologist and intensivist

• Karen Ann Klawitter, MD, board-certified pediatrician practicing telemedicine in Florida

• Nechama Sorscher, PhD, licensed child neuropsychologist, psychotherapist and author of Your Neurodiverse Child

• Tyler B. Evans, MD, MPH and cofounder of Wellness Equity

Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health