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Leilani Garel, a new mom from Markham, Ont., was hesitant to take Tylenol during her pregnancy, but was reassured by her doctor and midwife.EDUARDO LIMA/The Globe and Mail
In March, four months into her pregnancy, Leilani Garel was in excruciating pain with a bug she suspects was the flu.
Ms. Garel, who lives in Markham, Ont., rarely turns to over-the-counter medication and feared that taking it could affect her growing fetus. Having experienced a miscarriage before this pregnancy, she also carried an added burden of worry.
But several careful conversations later, including with her midwife and doctor, Ms. Garel felt confident in taking Tylenol to help quell her pain. She saw her symptoms ease.
“If you’re in pain, you need that relief,” Ms. Garel said, now a mom to one-month-old baby Samuel. “It’s there as an option. And you shouldn’t feel bad or feel that you’re doing something wrong by taking it, or that you’re a failure.”
Maternal health specialists are increasingly concerned that those who are expecting may decide against taking acetaminophen, the active ingredient in Tylenol, when they experience a fever or pain, after U.S. President Donald Trump warned earlier this week against its use.
After Mr. Trump’s announcement, the U.S. Food and Drug Administration also said it initiated a process to change the label for acetaminophen to reflect some evidence that suggests its use by those who are pregnant “may be associated with an increased risk of neurological conditions such as autism and ADHD in children.” The agency said it issued a letter to alert physicians in the U.S.
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Ms. Garel says Tylenol is ‘there as an option,’ and mothers shouldn’t feel bad about taking it during their pregnancy.EDUARDO LIMA/The Globe and Mail
Several medical doctors and health organizations, both in the U.S. and elsewhere, have rejected the President’s assertion and said the body of scientific literature does not support the claim that the drug causes neurological conditions. The maker of Tylenol, Kenvue Inc., also refuted Mr. Trump’s position.
Gynecologists say anti-inflammatory drugs, such as Advil, are not advised beyond 20 weeks gestation because of a risk of kidney damage to unborn babies, and that acetaminophen remains the safest option for pregnant patients to treat fever and pain. Not addressing these symptoms, they warn, carries documented health concerns, including a heightened risk of miscarriage and early labour.
Midwife Althea Jones, president of the Association of Ontario Midwives, said pregnancy is a unique and vulnerable journey for expecting parents who want to do what is best for their baby.
Additionally, because of how much online information is available at people’s fingertips, there is a lot to weed through, she said.
“It is a high stress time for a lot of people, and they feel a heightened sense of responsibility to be very careful with their bodies,” she said.
Gynecologists prepare for questions about Tylenol and pregnancy after Trump’s unproven claims
She added that based on the evidence, her recommendation for patients remains the same – that acetaminophen is safe to use in pregnancy as directed.
Susan Ellis, the chief of obstetrics and gynecology at St. Joseph’s Healthcare Hamilton, echoed this sentiment. She said she feels for pregnant patients, particularly ahead of the coming viral season this fall, when individuals often experience fever and pain associated with infections.
“As health care providers, it’s our responsibility to try and help pregnant persons to understand what the literature tells us and why we are making the recommendations that we are,” Dr. Ellis said.
“We are always working on the principle of first, do no harm, and trying to ensure the best outcomes for both the pregnant person and their newborn throughout that journey.”
She said obstetrical care providers are encouraging patients to take the flu shot and the RSV vaccine, which is used to protect against the respiratory virus that can cause serious illness in infants and older adults.
Last week, the Society of Obstetricians and Gynaecologists of Canada reaffirmed its position on acetaminophen use in pregnancy after a review of the latest body of scientific evidence.
It said patients should use the medication at recommended doses, for the shortest amount of time possible and when it is medically necessary.
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Health Canada issued a public advisory this week stating that acetaminophen, the active ingredient in Tylenol, is a ‘recommended treatment for fever and pain during pregnancy.’Michael Conroy/The Associated Press
Darine El-Chaar, a member of the SOGC who works with patients navigating high-risk pregnancies in Ottawa, said there was no scientific breakthrough that took place before Mr. Trump’s announcement. She said his comments could affect relationships between health care providers and patients.
Dr. El-Chaar said she will be encouraging patients to dissect the available information on the topic.
Some studies, including findings published in August in BioMed Central’s Environmental Health journal, showed acetaminophen in pregnancy can increase the risk of developing neurodevelopmental conditions such as autism and ADHD.
However, that study noted an association and not causation, Dr. El-Chaar said, adding that the researchers recognized the need for further research.
Additionally, a recent Swedish population study, regarded as the gold standard for scientific research, found no evidence of an increased risk of autism associated with the medicine.
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This week, Health Canada issued a public advisory stating that acetaminophen is a “recommended treatment for fever and pain during pregnancy.”
The department also said there is no conclusive evidence that using the medication as directed during pregnancy causes autism or other neurodevelopmental disorders.
Miriam Shahidi, a Toronto lawyer who is 22 weeks pregnant, has experienced migraines since childhood. She used to have the intense, throbbing headaches about once or twice a month. When they struck, she would turn to Advil to address her symptoms.
During pregnancy, her migraines have become much more frequent: usually three to four times a week.
In order to function for work, which requires her to look at a screen for many hours, Ms. Shahidi takes Tylenol to help alleviate symptoms – something she discussed with her OB/GYN.
Ms. Shahidi said she will follow what doctors say. But she said the recent debate over Tylenol use in pregnancy has generated additional worry for expecting parents.
“It still does create that level of stress and anxiety.”
