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Commentary: When you're pregnant and in pain -- A pharmacologist's guide to safe relief

Lyle D. Burgoon, Ph.D., ATS, Tribune News Service on

Published in Op Eds

Pregnancy comes with its share of aches and pains, including headaches, back pain, and general discomfort, all of which can make daily life challenging. For millions of women, acetaminophen (Tylenol) has been the trusted drug of choice, recommended by doctors and backed by decades of research showing it's safe when used as directed.

Now, with conflicting information swirling in Washington and the media, many pregnant women are now asking: What should I do when I'm in pain?

Echoing Health and Human Services Secretary Robert Kennedy Jr.’s concerns about acetaminophen and autism in children, President Donald Trump recently encouraged women to avoid the drug while pregnant and “tough it out.”

Declaring that “taking Tylenol is not good,” the president announced that the new-look Food and Drug Administration will be “strongly recommending that women limit Tylenol use during pregnancy unless medically necessary.”

As a pharmacologist and toxicologist who has spent years studying drug safety, here are some straightforward facts to help make informed decisions for yourself and your baby.

In terms of drugs, acetaminophen remains your safest bet. Every major medical organization, from the American College of Obstetricians and Gynecologists to the American Academy of Pediatrics, continues to recommend it as the preferred pain reliever during pregnancy. This isn't a casual recommendation. It's based on extensive research spanning decades and millions of pregnant women.

Ibuprofen and other “non-steroidal anti-inflammatory drugs” are off the table unless directed by your physician. According to the FDA, medications such as Advil and Aleve can cause a very rare, but serious, kidney toxicity that results in less amniotic fluid surrounding the baby if taken around 20 weeks of pregnancy and after.

"Toughing it out" isn't always wise. Severe or chronic pain during pregnancy can lead to stress, sleep problems, and other complications that aren't good for you or your baby. Managing pain appropriately is part of good prenatal care.

If you choose to use acetaminophen, here's how to do it right:

First, stick to the lowest effective dose. Take only what you need to manage your pain. If one tablet helps, don't take two.

Second, use it for the shortest time possible. This isn't a daily vitamin. Stop when you feel better.

Third, don't exceed 3,000 mg total per day unless directed by your physician.

Fourth, read all of the labels of the different products you take. Acetaminophen is found in a lot of popular over-the-counter medicines, including cold and flu remedies. Don’t accidentally double up your acetaminophen doses.

Medication isn't your only option. Consider these safe alternatives that can help manage pregnancy discomfort:

 

Heat and cold therapy can work wonders for sore muscles and headaches. A warm bath or heating pad on your back, or a cold compress on your forehead, might provide the relief you need.

Gentle exercise and stretching can help with back pain and general achiness. Prenatal yoga, swimming, or even regular walks can make a significant difference.

Good sleep support matters more than you might think. A pregnancy pillow that supports your changing body can prevent a lot of pain from developing in the first place.

Stress management techniques like deep breathing, meditation, or massage can help with tension headaches and muscle pain.

Here's what I hope every pregnant woman understands: When you see conflicting information about medications, the most important thing you can do is talk to your health care provider.

If, for example, you feel the need to take acetaminophen regularly for chronic pain, discuss this with your doctor or qualified midwife. They know your specific situation, your medical history, and can help you weigh the real risks and benefits.

Don't make medication decisions based on headlines or social media posts. Rely on your health care team and established medical and scientific organizations that base their recommendations on only the most rigorous and credible scientific research.

Finally, while I highly doubt there is a causal link between Tylenol and autism, understand that no doctor is in a position to eliminate every theoretical risk. It’s about making the safest choice possible. For most women in need of real relief from occasional aches and pains during pregnancy, that choice remains acetaminophen, used thoughtfully and as directed.

Trust the science, trust your health care provider, and trust yourself to make the best decision for your family.

____

Lyle D. Burgoon, Ph.D., ATS is a pharmacologist, toxicologist and president and CEO of the Center for Truth in Science and Science for Healthy Families, both of which provide science-based health information to help parents make informed decisions.

_____


©2025 Tribune Content Agency, LLC.

 

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