Why Headlines Can’t Help You Make Health Decisions: Birthsmarter’s Response to the recent Tylenol Controversy
Friday, September 26, 2025
Yesterday we hosted a company wide meeting. There were 14 of us on the call. Collectively we’ve given birth to 21 babies between the ages 12 months and 25 years old. Three of those kiddos have been diagnosed with autism.
Earlier this week, when the Trump Administration irresponsibly suggested that Tylenol usage in pregnancy was linked to rising rates of autism, I didn’t think about my role as CEO of Birthsmarter or our responsibility to help our students think critically about the news. I thought about the people I know personally, and love deeply, who would be most directly impacted by the news; three of whom are on the Birthsmarter team. What a mind f\*&k of a position to be put into.
If you are already pregnant, have recently given birth, are parenting a child who has been diagnosed with autism, or are autistic yourself, you know that this is not simply a theoretical controversy. You know that sweeping generalizations about causes of autism weigh heavily on your ability to get up in the morning and make breakfast with an iota of joy and presence. Not because having an autistic kid or being autistic yourself is inherently problematic but because guilt tends to be irrational.
At Birthsmarter we know that the last thing anyone who’s pregnant or parenting needs is another opportunity to feel as if they’ve done something wrong. In fact, one of the reasons I set out to write a new childbirth education curriculum, and launch Birthsmarter at all, was because I didn’t believe any new and expectant parents should experience the kind of guilt and self-doubt that plagued me after my home-birth-turned-hospital-transfer in 2014.
It’s with that renewed intention that I want to weigh in on the Tylenol & Autism conversation. While there have been many science communicators/physicians/creators including Dr. Phil Boucher and The Pediatrician Mom who posted helpful responses to the administration's statements – after our meeting today two things became clear. First, everyone, including Birthsmarter educators, could use a reminder on how to think critically in moments of high stress and high stakes. Second, our students are going to ask about acetaminophen usage in Birthsmarter classes and I needed to help our team understand how to answer that question in a Birthsmarter-aligned way.
The tl;dr is this: headlines can’t help you make health decisions.
While our role as childbirth educators is not to give medical advice or tell you what to do or not do, we work hard to help parents cut through the noise, think critically, and make confident decisions. We also want to help grandparents, well-intentioned friends, and perinatal professionals think critically so they do not cause additional harm or stress to pregnant family, friends, or clients.
So, let me walk you through this as if we were teaching using The Birthsmarter Framework and the BRAIN acronym.
The Birthsmarter Framework
The Birthsmarter Framework proves, logically, that there is no “one right way” or single recommendation that can be universally applied in pregnancy, labor, or postpartum. The framework maps out three overlapping domains that every birth and parenting decision exists within.
- We look at the physiological process and ask what is universally true based on how human bodies work.
- We take the societal context into account because we do not make health decisions in a vacuum.
- We consider our personal circumstances since no two people approach pregnancy or parenting with the same ingredients.
When it comes to autism and acetaminophen use in pregnancy, what do we know to be true physiologically? The truth is, very little.
We know that some things, like high fevers or heavy alcohol consumption, can negatively impact fetal development. And that while there is a genetic component to autism, scientific research has still not identified a single cause. The Trump administration did not present a scientific breakthrough identifying the cause of autism, nor did they present any physiological explanation for how acetaminophen affects fetal brain development. In science, a true causal link requires not just correlation but also a plausible biological mechanism. That piece is missing here, which makes it even more important to treat these claims with caution.
To be clear, despite the flurry of headlines, the actual medical recommendations about Tylenol use in pregnancy have not changed.
Societally, how we talk about medicine and autism is loaded.
We live in a culture that normalizes over-the-counter medication as a first line of defense. Many people reach for pharmaceutical support at the first sign of a cold, seasonal allergies, or a stomachache. Coming out of the sports world, I can think of dozens of people who pop ibuprofen (“vitamin I”) without a second thought. Like anything, our relationship with medication often falls along a spectrum. On the other end are individuals who avoid medication at any cost.
This polarization matters. When decisions about taking Tylenol, or other medications, are framed as a matter of identity, politics, or morality, people are pushed to extremes rather than supported in finding the nuanced, science-informed path that is right for them. (Honestly, the same is true with any medical intervention. Enter: conversations around getting an epidural or having a cesarean birth.) We also need to remember the larger backdrop. Pharmaceutical companies have huge financial stakes. Marketing is often unregulated. Government involvement increasingly muddies the waters.
On top of this, we have to consider how the culture of the United States has responded to autism. While the “vaccines cause autism” narrative has been debunked over and over again, its remnants are still present. Before we jump to reactionary research, we should ask: are increasing autism rates inherently bad, or is the lack of social services, inclusive schools, and support for autistic individuals and their families what is actually backbreaking for modern parents? Is our current administration's quest to find a root cause of autism rooted in ableism? These are uncomfortable but necessary questions.
Personally, every pregnancy is different.
Everyone comes with a unique family history and relationship to medication, and a unique family history and relationship to neurodivergence. Everyone has a different relationship to pain: common aches and pains in pregnancy, for example, are wildly different from chronic pain and chronic migraines. Everyone has a different level of worry about pregnancy loss or miscarriage. This is why blanket statements about what all pregnant people should or should not do are not just unhelpful, they are harmful.
Practical Tools: The BRAIN Framework
When faced with any medical choice in pregnancy (or labor) we teach folks to use their BRAIN. For acetaminophen in pregnancy, it would look like this:
- B – Benefits: Why would you take acetaminophen? What are you hoping to gain? Relief from fever, aches, or pains.
- R – Risks: What are the potential risks? There are no established risks to date.
- A – Alternatives: For fever? There are no safe alternatives (and untreated fevers can cause real harm). For aches or pains: strength training, physical therapy, yoga, acupuncture, massage, posture and breath work, baths, magnesium cream, or nutritional support.
- I – Instinct/Intuition: What does your gut say? Could alternatives be helpful, or do you need medication? And can you tell the difference between your instinct (a deep knowing) and anxiety (spiraling thoughts)?
- N – Now?: Do you need it immediately, as in treating a fever, or can you wait and reassess? What would happen if you did nothing?
The Bigger Picture
We cannot have this conversation without naming a few elephants in the room. First, our healthcare system gatekeeps access to supportive care since insurance companies often do not cover non-pharmaceutical treatments like massage, physical therapy, or acupuncture. Second, misogyny is baked into the way our society treats reproductive health care. We see this with barriers to birth control, abortion care, physiological birth, wrap-around postpartum care, parental leave, and childcare. So, if the government suddenly wants pregnant people to rely less on pharmaceuticals, alternatives need to be accessible and affordable. Otherwise, these conversations only add guilt while placing the burden on individuals to fix problems created by systemic wrongdoing.
Parents in the United States are already carrying enormous responsibility without adequate support. Guilt helps no one and harms everyone.
Where Do We Go From Here?
Look: it’s NOT enough. But, at Birthsmarter, we believe in focusing on what is in your control: building trust, safety, joy, and movement into daily life. This is a good moment to step back from social media and silence your news alerts. Urgent news will find you.
Go outside. Play music. Dance. Draw. Bake. Spend time with friends. Drink water. Move your body. Breathe deeply.
We cannot erase the noise or impact of the news cycle, and we guarantee it will not be long before the next round of alarming headlines hit our screens. What we can do is help you build tolerance and resilience for navigating complex times (we call it Childbirth Education!)
If you know someone who is pregnant and wants to learn how to approach birth planning with logic, curiosity, and unbiased, science-informed thinking, we would love to see them in a Birthsmarter childbirth education class. We teach in-person across the country, live on Zoom, and on-demand. Our classes are inclusive for all family structures, birthing in any setting, and accessible via Alternative Pricing.
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