This week, comments from U.S. President Donald Trump have stirred up controversy about the safety of acetaminophen, or the brand Tylenol, to treat women’s pain during pregnancy.

However, Canadian experts argue that these concerns are not new, and the science hasn’t changed. The Society of Obstetricians and Gynecologists of Canada maintains there’s no clear evidence linking acetaminophen to autism or other developmental issues.

To help us understand what the research actually shows and what expecting mothers need to know, London Morning host Andrew Brown spoke with Dr. Janine Hutson, a maternal fetal medicine specialist and OBGYN in women’s care at London Health Sciences Centre.

The following has been edited for length and clarity:

Andrew Brown: What did you think about what we heard from Mr. Trump and Mr. Kennedy this week?

Dr. Janine Hutson: It’s not really new information. A review published in 2021 raised these concerns, and the Society of Obstetrics and Gynecology of Canada put out a statement at that time. We made it clear there was no strong evidence that acetaminophen caused autism or behavioural effects. It’s also been linked in some studies to lower IQ, but none of those findings have been substantiated. Our position in 2021 was that acetaminophen should still be used when medically indicated, at the lowest effective dose, but without concern if needed.

AB: What would people need it for?

JH: It’s commonly used for fever or pain.

AB: As you say, the link with autism hasn’t been established, but it’s been looked into.

JH: Yes, there are multiple studies. The challenge is that it’s very hard to study medications in pregnancy because we can’t run randomized controlled trials. Most of the research is retrospective, looking back at what women took during pregnancy and trying to link that to outcomes.

Those studies often rely on databases, and we don’t always know the timing, the dose, or even whether the pregnant person actually took the medication. So the data [isn’t] very strong. Some studies say there is a link, others say there isn’t. When you look at all the evidence together, there just isn’t proof that acetaminophen causes autism.

LISTEN | Dr. Janine Hutson talks treating women’s pain on London Morning:

London Morning6:26Women’s pain management

This week, the U.S. administration said pregnant women should avoid Tylenol or acetaminophen during pregnancy because of the potential link to autism in the baby. London Morning checked the facts around that with Dr. Janine Hutson, a Maternal Fetal Medicine Specialist and OBGYN at Women’s Care, London Health Sciences Centre.

AB: Let’s step back a little. How has pain management in women’s health changed over the years?

JH: We don’t have many options in pregnancy. Non-steroidal anti-inflammatory drugs — ibuprofen, naproxen — can’t be used later in pregnancy because of clear links to kidney damage in babies. That eliminates one of the main categories of pain medication. Beyond that, we really only have acetaminophen, which we still encourage when needed, and then narcotics as the next step for more severe acute pain.

AB: Is this something that has been overlooked or dismissed historically?

JH: Definitely. It’s common that when we don’t know enough about a medication, or aren’t familiar with it, the default is just to say a pregnant person shouldn’t take it.

AB: Why is it so important? Does it go beyond just short-term pain relief?

JH: Yes. For many people, pain relief is what allows them to go to work and keep their jobs. Untreated pain can lead to other health problems, including high blood pressure, which has serious consequences in pregnancy. We also know treating pain can bring blood pressure down. So it’s much bigger than short-term relief.

AB: As you see it, what has to change?

JH: The FDA has shifted toward recommending risk–benefit conversations, rather than labelling medications as simply safe or unsafe. That’s the approach we need. Healthcare providers should be talking openly with patients about the risks and benefits of using or not using a medication, rather than treating it as a yes or no decision.

AB: When the president of the United States makes comments like he did earlier this week, what impact could that have?

JH: We’ve already seen the effects. At OB triage in London, our emergency unit for pregnant patients, we’ve had people refuse acetaminophen or Tylenol. We get questions all the time. It leaves patients uncertain and feeling guilty, as if they’re being judged for taking it. It’s had a real negative effect, despite there being no new evidence.

AB: So when someone comes in and says, “I’m not taking acetaminophen,” what do you tell them?

JH: We reassure them there’s no clear link to autism and point out that virtually every medical society in the world supports its use when medically necessary. That includes the Society of Obstetrics and Gynecology of Canada, the Society for Maternal-Fetal Medicine, and the World Health Organization. Everyone still recommends it as safe for pregnancy when needed.