Politicians have never been known for medical restraint. In the United States, one has declared that pregnant women should “tough it out” rather than take paracetamol, warning that use in pregnancy may cause autism.
The problem with pronouncements like these is that they are not just comedy for late-night hosts. They land in the laps of real women, with real pregnancies, facing real choices about pain, fever and health. They make headlines, trigger panic and sow distrust—without nuance, without context and without compassion.
Paracetamol (also called acetaminophen in the United States) is one of the most widely used medications in the world. For decades, it has been considered safe in pregnancy. Millions of women have relied on it for headaches, fever or body aches when few other drugs could be taken without risk.
In recent years, however, observational studies have raised questions. Some research has suggested a possible link between prolonged or high-dose use of paracetamol in pregnancy and an increased risk of neurodevelopmental issues, including attention-deficit hyperactivity disorder (ADHD) and, more controversially, autism spectrum disorder (ASD).
But here is the crucial point: correlation does not equal causation. The studies are limited. Confounding factors—like maternal infections, genetics, stress and even why paracetamol was taken in the first place—make it difficult to separate signal from noise. Major health organisations, including the UK’s National Health Service (NHS), have not changed their advice: paracetamol remains the recommended first-line analgesic in pregnancy, provided it is used in the lowest effective dose for the shortest duration necessary.
For readers unfamiliar with Margaret Atwood’s The Handmaid’s Tale, imagine a dystopian society where women’s bodies are no longer their own. In the Republic of Gilead, fertility is prized, and women are reduced to their biological function. Doctors are controlled, evidence is suppressed, and decisions about women’s health are made by male politicians quoting scripture.
It is fiction. But it does not feel distant when politicians begin telling pregnant women what they should and should not endure, not on the basis of science but of gut instinct and politics.
Anyone who has carried a child knows that nine months can bring nausea, back pain, migraines, fevers and sometimes serious complications. To deny women safe relief is to treat them not as people but as vessels, valued only for reproduction and expected to suffer in silence for the supposed greater good.
Pain in pregnancy has always been political. In many cultures, women are told that suffering is their lot, a necessary sacrifice for motherhood. Too often, their pain is dismissed as exaggeration or weakness.
The irony is that untreated fever in pregnancy—a condition paracetamol is often used to manage—is known to increase risks of miscarriage, preterm labour and developmental harm to the fetus.
Autism spectrum disorder is a complex neurodevelopmental condition with no single cause. Genetics play a significant role. Environmental factors may contribute, but the science is evolving.
The danger of linking autism casually to something as common as paracetamol is twofold:
1. It fuels guilt among mothers. Parents of children with autism already face stigma and self-blame. To suggest that a tablet for a fever “caused” their child’s condition is cruel and unproven.
2. It distracts from real research. Instead of investing in better understanding of genetics, early intervention, and support systems, energy gets wasted chasing simplistic villains.
We have seen this before. The discredited claim that vaccines cause autism has had devastating consequences, lowering vaccination rates and fuelling outbreaks of measles.
When a world leader casually speculates about medicine, his words ripple far beyond the podium. Pharmacies may see anxious mothers refusing paracetamol. Doctors may find themselves battling misinformation instead of treating patients. Women may suffer needlessly with pain or fever, believing they are protecting their babies when in fact they may be putting them at greater risk.
So, what should women know?
Paracetamol is still the safest analgesic in pregnancy. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are generally avoided, especially in later pregnancy, due to risks to the fetus.
Use matters. Occasional use for a headache or fever is not the same as long-term, high-dose use. The latter may carry risks and should be discussed with a doctor.
Fever is dangerous. Do not “tough it out.” A high maternal temperature is harmful to both mother and child.
Talk to your doctor. Every pregnancy is unique. Medical advice should come from healthcare professionals, not campaign rallies.
This is nuance. It may not fit into a tweet, but it respects women enough to give them the truth. Women are not incubators. They are not extras in a political drama. They deserve autonomy, dignity and accurate information.
Don’t tough it out. Don’t fall for slogans. Trust the science, trust your doctors, and most of all, trust women.
