The Society for Maternal-Fetal Medicine published new clinical guidance this week affirming that acetaminophen, better known by its brand Tylenol, should be the “first-line” defense against pain and fever during pregnancy. 

The directive contradicts the Trump administration’s notice to physicians last year cautioning against the use of the primary pain reliever recommended for pregnant women, following the president’s unsupported claims that the medication could lead to autism in children.

The national professional association for maternal-fetal medicine specialists, clinicians and scientists continues to recommend acetaminophen as the “first-line medication” to treat pain and fever during pregnancy. The federal government’s statements prompted the organization to review its 2017 guidance finding acetaminophen safe to use during pregnancy. 

Trump ties autism to Tylenol use in pregnancy despite inconclusive scientific evidence

“Although some studies have reported associations between maternal acetaminophen use and adverse neurodevelopmental outcomes in offspring, methodological limitations preclude conclusions about causality, and the biological mechanism for such an effect remains unestablished,” reads the statement, following a comprehensive review of recent and historical scientific literature. 

The organization’s guidance cautions patients to “use the lowest effective dose of acetaminophen for the shortest duration necessary,” while emphasizing that untreated maternal fever carries well-documented risks to the fetus, especially in the first trimester.

At a news conference last September, President Donald Trump said his administration had found acetaminophen use during pregnancy to be a likely contributing environmental cause of autism. 

Health and Human Services Secretary Robert F. Kennedy Jr. has directed the U.S. Food and Drug Administration to shift its research into autism toward potential environmental causes. 

Even though medical experts and the drug manufacturer have said there is no proven link, the FDA immediately said it would initiate a process for a label change for Tylenol and similar products to “reflect evidence suggesting that the use of acetaminophen by pregnant women may be associated with an increased risk of neurological conditions such as autism and ADHD in children.”

The label has not yet changed. But the September news conference has had consequences.  

A month later, Texas’ Republican Attorney General Ken Paxton, who is running for U.S. Senate, sued Johnson and Johnson, alleging the pharmaceutical company failed to warn pregnant consumers about the risk of taking Tylenol.

And a study in The Lancet published in March found that emergency department orders for acetaminophen for pregnant patients fell 10% in the months following Trump’s statement, while there was no change in the acetaminophen orders for comparable women who were not pregnant.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org. 

One of the main methods of obtaining abortion medication for those living in states with bans is now blocked nationwide, after a federal appeals court decision issued Friday afternoon.

The 5th Circuit Court of Appeals blocked a U.S. Food and Drug Administration rule from 2023 that allowed mifepristone, one of two drugs used to terminate a pregnancy before 10 weeks and to treat miscarriages, to be dispensed without an in-person visit with a health provider. 

In the years since, states with abortion access have increased their telemedicine offerings to prescribe the medication remotely and send it through the mail. Many of those states also enacted shield laws to prevent officials from states with abortion bans from prosecuting or investigating their providers — meaning many patients have been able to receive the medication across state lines.

Louisiana judge preserves telehealth abortion access provision for now, puts case on hold

The block will remain in effect as the lower court case proceeds, but the FDA could file an emergency appeal to the U.S. Supreme Court in the coming weeks.

More than 27% of all abortions were provided through telehealth appointments in the first six months of 2025, according to the Society of Family Planning, a research and advocacy group that publishes a report called #WeCount. Nearly 15,000 abortions per month were provided under shield laws during that same time frame, according to the report.

Louisiana Republican Attorney General Liz Murrill sued the FDA in October, seeking to strike down the 2023 provision, and the lower court declined to do so in early April. U.S. District Judge David C. Joseph said then that the stay was premature while the FDA completed a safety review of mifepristone, but allowed state officials the opportunity to re-file the motion after that review was complete. The state appealed that decision to the 5th Circuit.

“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is human being from the moment of conception and is, therefore, a legal person,’” Friday’s decision said.

There were no dissenting opinions among Judge Leslie Southwick, an appointee of former Republican President George H.W. Bush, and Judges Stuart Kyle Duncan and Kurt D. Engelhardt, both appointees of Republican President Donald Trump.

Without access to telemedicine and the opportunity to receive the medication through the mail, people in 13 states with near-total abortion bans may have to travel to another state to get an abortion.

There is a misoprostol-only abortion pill protocol that some providers can use, but it is slightly less effective and requires a higher dosage, which can increase side effects.

“Reinstating in-person dispensing requirements would force people to travel farther, take more time off work, and absorb costs that are simply too high. For people living in states already hostile to abortion access, many of which are home to Black women and families, this is not health care,” said Regina Davis-Moss, CEO of advocacy group In Our Own Voice: National Black Women’s Reproductive Justice Agenda, in a statement. 

Murrill said in a statement on Friday that former Democratic President Joe Biden’s administration facilitated “illegal mail-order abortion pills.”

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“Today, that nightmare is over, thanks to the hard work of my office and our friends at Alliance Defending Freedom. I look forward to continuing to defend women and babies as this case continues,” Murrill said, crediting the advocacy legal organization that helped in the case.

The court also found Friday that the 2023 rule injures Louisiana by causing it to spend Medicaid funds for emergency care for women harmed by using the drug. The state identified $92,000 paid by Medicaid for two women who needed emergency care in 2025 from complications “caused by out-of-state mifepristone.”

Numerous studies have shown mifepristone is safe to use, with very low complication rates. A combined review of 10 years’ worth of studies between 2005 and 2015 found that severe outcomes requiring blood transfusion and hospitalization occurred in less than 1% of cases.

“We are alarmed by this court’s decision to ignore the FDA’s rigorous science and decades of safe use of mifepristone in a case pursued by extremist abortion opponents. We are reviewing the court’s order in detail,” said Evan Masingill, CEO of GenBioPro, one of the main manufacturers of mifepristone, in a statement. “We remain committed to taking any actions necessary to make mifepristone available and accessible to as many people as possible in the country, regardless of anti-abortion special interests trying to undermine patients’ access.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.