Better Safe than Sorry? Tylenol, Pregnancy, and Ethics

“Don’t take Tylenol,” President Trump told pregnant women last week. Despite his claims, there is no evidence that Tylenol taken during pregnancy increases the risk of autism, ADHD, or intellectual disability in children. Misinterpretation of scientific evidence is not just an issue of reporting, but one of ethics. Bioethicists must call out this misleading, fear-based rhetoric.

Deciphering whether any medication causes harm to fetuses is complicated. Part of the challenge is a longstanding reluctance to conduct research during pregnancy. The 2018 revision to the Common Rule removed pregnant women from the list of those considered a “vulnerable population,” and leading organizations have called on the scientific community to address evidence gaps through responsible inclusion of pregnant women in biomedical research. But fewer than 1% of clinical drug trials of women ages 18 to 45 enroll pregnant participants.

Remarkably, despite these challenges, Tylenol is among the few medications for which we have a good evidence base. This is not because randomized trials have been done––but rather because Tylenol use has become so widespread