Canadian obstetricians say Tylenol is still safe to take in pregnancy after position review

Extra-strength Tylenol tablets are seen, Tuesday, Sept. 12, 2023 in Chelsea, Que. THE CANADIAN PRESS/Adrian Wyld

TORONTO — A group representing Canada’s obstetricians and gynecologists says it has reviewed evidence on Tylenol use during pregnancy and maintains that the painkiller is safe.

The Society of Obstetricians and Gynaecologists of Canada said on Monday that it has revisited its position in light of reports questioning whether there is a link between mothers taking acetaminophen while pregnant and autism in children.

The Wall Street Journal recently published a story that said U.S. Health Secretary Robert F. Kennedy Jr. plans to release a report this month linking autism to the use of the common painkiller in pregnancy.

“We want to get ahead of it, ahead of the media and the social media, and unfortunately the misinformation that goes along with this,” said Dr. Graeme Smith, editor and chief of the Journal of Obstetrics and Gynaecology Canada.

The SOGC said there is no causal evidence linking prenatal exposure to acetaminophen and certain neurodevelopmental disorders. That’s consistent with the American College of Obstetricians and Gynecologists’ stance.

It also said untreated fever in pregnancy carries well-documented risks for both mother and baby, and that pain management is a human right that women should not be denied.

An untreated fever, particularly in the first trimester, carries an increased risk of miscarriage, birth defects, and premature birth, according to the Society for Maternal-Fetal Medicine.

In general, health agencies and doctors say acetaminophen is OK to use in pregnancy when medically needed, at recommended doses and for the shortest duration necessary.

A Nature Reviews Endocrinology editorial in 2021 questioned the safety of acetaminophen in pregnancy, bringing attention to the issue.

In response, SOGC released a position paper that year stating that the evidence for causality claims has many fundamental flaws that should not change current clinical practice. That includes factors known to increase the risk of neurodevelopment in children, such as genetics and certain health conditions, not being taken into account.

“Opinions based on limited or flawed evidence should not promote unwarranted fear and guilt in pregnant women,” the position paper says.

Smith said the article showed a “potential association” between prenatal exposure to acetaminophen and fetal development. But he said an association doesn’t equate to a causation.

“There’s certainly no data to show cause and effect,” Smith said on Tuesday.

He said a large NIH-funded study looking at this same issue found that when researchers compared the neurodevelopment of siblings, there was no increased risk when one sibling was exposed to acetaminophen in the uterus and the other was not.

“This suggests that associations observed in other models may have been attributable to familial confounding,” the study concluded.

This report by The Canadian Press was first published Sept. 16, 2025.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Hannah Alberga, The Canadian Press