If you are pregnant and run a fever or have a pounding headache, the first medication many doctors have historically recommended is acetaminophen, best known by the brand name Tylenol. Here’s the story of how that guidance took hold, what recent research and statements say, and how a pregnancy safe ingredient checker like the SafeMom app can help you choose everyday products with confidence.
A quick history lesson
Acetaminophen has been around for more than a century, but it didn’t become widely used until the mid-20th century. It entered U.S. markets in the 1950s and grew quickly as an alternative to aspirin for pain and fever. By the 1980s it had surpassed aspirin in many countries because it was easier on the stomach and broadly effective for mild to moderate pain.
Why it became the default in pregnancy
For decades, obstetric practice weighed two things: 1) keeping mom comfortable and fever-free, and 2) avoiding medicines with known fetal risks. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen help pain and fever, but they carry specific pregnancy risks, especially later in pregnancy. In 2020, the U.S. FDA warned against NSAID use at 20 weeks or later because of fetal kidney problems and low amniotic fluid. That reinforced what many OBs already practiced: if you truly need a pain or fever reducer during pregnancy, acetaminophen is generally the first choice.
Professional groups have echoed that stance. The American College of Obstetricians and Gynecologists (ACOG) has long stated that acetaminophen, when used as needed and in moderation under medical advice, is an appropriate option in pregnancy.
The newer debate: signals vs proof
Over the last decade, some observational studies reported associations between prenatal acetaminophen exposure and neurodevelopmental outcomes like ADHD or autism. Associations aren’t the same as cause. When researchers used designs that better account for genetics and family factors, those links often weakened. A large Swedish study published in 2024, using sibling comparisons across 2.5 million children, found no association between prenatal acetaminophen use and autism, ADHD, or intellectual disability after controlling for familial confounding.
In 2021, an international group of researchers issued a “call for precautionary action,” suggesting pregnant patients minimize exposure by using the lowest effective dose for the shortest time and to avoid long-term use unless medically indicated. That statement fueled public discussion but did not prove causation.
What health authorities are saying right now
Recent headlines have kept this topic front and center. In September 2025:
- ACOG reaffirmed that acetaminophen plays an important and safe role for pregnant patients when used appropriately.
- The World Health Organization stated there is no conclusive evidence linking acetaminophen use in pregnancy to autism, cautioning against misinformation.
- The FDA circulated a physician notice and indicated it is evaluating labeling language in light of recent studies. Regardless of ongoing review, the agency’s long-standing guidance about avoiding NSAIDs in later pregnancy remains unchanged. Always discuss any medication decision with your clinician. (U.S. Food and Drug Administration+2U.S. Food and Drug)
Bottom line from major medical organizations: if you are pregnant and truly need a fever or pain reducer, acetaminophen remains the preferred over-the-counter option when used at the lowest effective dose for the shortest time and in consultation with your care team. Untreated high fever can pose risks during pregnancy, so decisions should balance potential risks and benefits. (ACOG)
Practical tips for using acetaminophen in pregnancy
- Talk to your OB or midwife before taking any medication, including over-the-counter products.
- Use the lowest effective dose for the shortest time. Avoid chronic, routine use unless advised. (PubMed)
- Check every label. Acetaminophen hides in many cold, flu, allergy, and sleep products. You want to avoid accidentally taking two products that both contain it. (There are 600+ medications that include acetaminophen.)
- Avoid NSAIDs like ibuprofen or naproxen, especially after 20 weeks, unless your clinician specifically tells you otherwise.
Everyday products matter too — here’s where SafeMom helps
Medication is only one piece of daily life during pregnancy. The lotions, shampoos, serums, sunscreens, and cosmetics you use also come with long ingredient lists that can be hard to decode. That’s why we built SafeMom.
- Use SafeMom as your pregnancy ingredient checker to scan barcodes or search products and instantly see if ingredients are flagged for pregnancy.
- SafeMom doubles as a pregnancy safe ingredient checker, helping you spot common concerns and find alternatives that fit your routine.
- You get simple “use,” “use with caution,” or “avoid” guidance for many everyday products, plus links to learn more so you can talk with your provider.
While you and your clinician decide whether acetaminophen is appropriate for a specific symptom, SafeMom can make the rest of your routine simpler by checking the other products you reach for every day.
The take-home
- Historically, doctors recommended acetaminophen as the preferred choice for pain and fever in pregnancy because it works and has a stronger safety profile than NSAIDs later in pregnancy.
- Some studies raised questions about neurodevelopmental risks, but higher-quality analyses and leading organizations have not found proof of a causal link. Guidance today supports careful, minimal, medically guided use.
- Always discuss medication decisions with your clinician, and use tools like SafeMom’s pregnancy ingredient checker to simplify choices on the non-medication products you use daily.
