Tylenol Use in Pregnancy

The recent announcement by the U.S. Department of Health and Human Services (HHS) regarding prenatal acetaminophen (Tylenol) use is not backed by the full body of scientific evidence. At Advantia Health, we are committed to the safety of you and your baby, and encourage you to talk to your healthcare provider if you have questions about acetaminophen or any other medications during pregnancy.

Is Tylenol Safe to Take During Pregnancy?

The American College of Obstetrics and Gynecology (ACOG) and the Society of Maternal-Fetal Medicine (SMFM) agree that pregnant patients can continue to rely on acetaminophen for managing pain and fever.

As many who are familiar with autism know, autism is primarily genetically established before birth through complex factors beyond anyone’s control. A nationwide Swedish cohort study of nearly 2.5 million children, born between 1995 and 2019, found no significant association between acetaminophen use during pregnancy and increased risk of autism, ADHD, or intellectual disability after accounting for familial and medical confounders. The authors concluded that the previously reported associations between acetaminophen use in pregnancy and neurodevelopmental disorders are likely attributable to familial or genetic confounding rather than a causal effect of the drug.

How Tylenol Works in the Body

Acetaminophen (Tylenol) is in a different class of pain relievers from non-steroidal anti-inflammatory medications like ibuprofen, which means it is highly effective at lowering fever and easing pain, but does not reduce swelling or inflammation. It is believed to reduce fevers and improve pain tolerance by inhibiting enzymes in the brain that regulate temperature and signal pain. When you ingest acetaminophen, it is processed by the liver and later excreted in the urine.

Risks of Taking Tylenol During Pregnancy

The risks of untreated fever during pregnancy are well-established. Fevers above 100.4F in the first trimester are proven to increase risk of miscarriage, neural tube defects, congenital heart issues, stillbirth, and preterm delivery. Taking acetaminophen when needed and in limited amounts can decrease the likelihood of these complications. Other options like ibuprofen are not recommended in pregnancy as they can cause serious complications in your baby.

Safe Tylenol Dosage During Pregnancy

For a healthy adult who weighs at least 150 pounds, the maximum safe dose is 4,000 milligrams (mg) within a 24-hour period to prevent liver damage. However, for those with liver disease or other health conditions, the recommended dosage may be lower. Because medicines may not be safe to take with acetaminophen, it is important to let your provider know of any other medications you may be taking.  

Whenever taking any medication, the goal is to use the lowest effective dose for the shortest time needed. If you need to use acetaminophen for more than a few days during pregnancy or if you have any concerns, please contact your Advantia Health provider.

Alternatives and Complementary Pain Relief Options

For fever reduction and severe pain, acetaminophen is the safest available pain relief option. Acetaminophen alternatives are not recommended during pregnancy due to risk to the fetus. 

Round ligament pain, back pain, headache, and muscle soreness are all common during pregnancy as the uterus grows and you gain weight, muscles weaken, and ligaments relax. For minor discomfort, you can explore a number of additional strategies. 

These include:

• Back massage, heating pad (on lowest temperature setting), warm water bottle (wrapped in a towel), or ice pack
• Pregnancy or maternity belt
• Wearing supportive shoes (with arch support and low heels)
• Rest
• Regular physical activity
• Physical therapy
• Complimentary therapies, such as acupuncture or chiropractic treatment

Before starting an exercise program or complementary therapy such as chiropractic treatment, be sure to check with your healthcare provider. For serious or persistent pain, or pain accompanied by fever, cramping, vaginal bleeding, contractions, or a burning sensation during urination, contact your healthcare professional immediately.

Talk to a Women’s Health Expert Today

During pregnancy, it is important to share with your healthcare provider when you are experiencing prolonged or severe pain, fever, or other signs of serious complications. Your provider can offer guidance that is appropriate for your situation. 

For additional guidance and evidence-based resources on this topic, we encourage you to explore the following trusted organizations:

Society for Maternal-Fetal Medicine Statement

American College of Obstetricians and Gynecologists Statement