How Trump’s warnings shifted ER Tylenol prescriptions for pregnant women
Fewer pregnant women were prescribed acetaminophen in emergency rooms nationwide in the weeks after President Donald Trump warned Americans that the drug could cause autism in unborn children, researchers reported Thursday.
Acetaminophen — also called paracetamol — is the active ingredient in over-the-counter fever and pain relievers such as Tylenol.
During a September 2025 White House briefing, Trump urged pregnant women not to take the drug.
“Don’t take Tylenol, don’t take it,” he said repeatedly. “Fight like hell not to take it. There may be a point where you have to, and you have to work it out with yourself.”
That same day, the Food and Drug Administration moved to change warning labels on products containing acetaminophen and published a notice to physicians echoing Trump’s concerns.
“In recent years, evidence has accumulated suggesting that the use of acetaminophen by pregnant women may be associated with an increased risk of neurological conditions such as autism and ADHD in children,” FDA commissioner Martin Makary wrote in a letter. “The association is an ongoing area of scientific debate and clinicians should be aware of the issue in their clinical decision-making.”
New analysis released
Emergency rooms immediately began issuing fewer acetaminophen prescriptions for pregnant women, according to a new analysis published as a research letter in The Lancet. Three weeks after the announcement, data show the prescription rate for nearly 90,000 pregnant women reached a 20% decline. The rate gradually rose again, returning to previous levels after about 11 weeks, the Lancet reported.
The rate of acetaminophen prescriptions did not change among the more than 850,000 women who were not pregnant and visited an emergency room during the same period.
Researchers could not say definitively that the drop in acetaminophen prescriptions among pregnant women was directly caused by Trump’s remarks or the FDA’s letter, but the study’s authors noted it was a likely explanation. It is also unclear if the drop in prescriptions was driven by patients refusing the drug or fewer physicians using it.
The study illustrates the real-world influence political leaders can have on health decisions.
“The federal health authorities really do have a lot of power in capturing public health attention,” Michael Barnett, a Brown University professor and second author of the Lancet paper, told NBC News. “All of us in the public health community want them to use this power for good, and to use the best available evidence.”
What does the science say?
Numerous health organizations — including the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics — pushed back against Trump’s remarks.
“Any association between acetaminophen and autism is based on limited, conflicting and inconsistent science and is premature,” Autism Science Foundation Chief Science Officer Dr. Alycia Halladay said in a press release issued hours after Trump’s statements.
Some studies have suggested that acetaminophen use during pregnancy could increase the risk of certain conditions in the developing fetus.
Last year, researchers reviewed 46 existing papers on the topic; of those, 27 studies reported that acetaminophen use during pregnancy was related to an increased risk of a child developing autism and ADHD. Nine studies found no association, and four found that acetaminophen may prevent neurodevelopmental disorders. Many studies also found a dose-response relationship, researchers reported, meaning that higher levels of acetaminophen consumption were associated with a higher risk of a child developing autism or ADHD.
In 2021, a group of 91 scientists, clinicians and public health professionals published a consensus statement noting acetaminophen’s potential to interfere with fetal development and increase risks of some neurodevelopmental, reproductive and urogenital disorders.
The body of scientific evidence does not, however, prove that acetaminophen causes autism or other neurodevelopmental disorders.
Fever itself has been linked to a higher risk of autism, and because acetaminophen is the only medication recommended to treat fever during pregnancy, its use may simply signal a fever was present. In other words, acetaminophen may appear in the data because it is used to treat an underlying illness, not because the drug directly affects the developing baby.
Several other notable studies have found no link between acetaminophen and autism. One large Swedish study that followed nearly 2.5 million children compared siblings within the same families — where one child was exposed to acetaminophen in the womb and another was not — and found no increased risk.
Another meta-analysis published earlier this year reviewed 43 studies and found no strong evidence that taking acetaminophen during pregnancy significantly increased the risk of children developing autism, ADHD or intellectual disability.
Hugh Taylor, chief of obstetrics and gynecology at Yale New Haven Hospital and one of the physicians who signed the 2021 consensus statement raising concerns about acetaminophen exposure during pregnancy, said that, taken together, the evidence suggests that any risk from the drug is likely small.
“People should be reassured. Overwhelmingly, the data here seems to suggest that acetaminophen is quite safe to use in pregnancy,” he said. “Certainly by not using it or using alternatives have clear associated risks and harms. We should not be avoiding it and taking on new or even greater risks.”
The Lancet paper reported that prescriptions for other pain relievers, such as opioids, did not increase among pregnant women even as acetaminophen usage declined.
Prescriptions for autism drug spiked
During the same press conference in which Trump warned pregnant women about Tylenol, Makary announced that the agency had approved leucovorin — a drug historically used to treat symptoms of chemotherapy — as a treatment for autism.
Researchers found that in the 11 weeks following the announcement, prescriptions for the drug increased by 71% among 5- to 17-year olds. A handful of small studies have found that leucovorin improves motor and language skills among some children.
“The announcement put leucovorin on families’ radar, so they started asking for it,” Audrey Brumback, a pediatric neurologist at the University of Texas at Austin, told The New York Times.
Ella Rae Greene, Editor In Chief
