Paracetamol in Pregnancy: What the Evidence Says
Medically Reviewed by Dr. Pedro Yelamo Vera, MD
Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026
Paracetamol is still the first-choice painkiller in pregnancy. What the EMA, AEMPS, MHRA and ACOG concluded about the autism claim, and how to use it well.
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Dr. Pedro Yelamo Vera is an independent, bilingual GP licensed in Spain. Book a 15-minute video consultation in English or Spanish for €50, with a private electronic prescription issued under Spanish law when clinically appropriate.
Yes. Paracetamol is still the first-choice painkiller in pregnancy. In September 2025, European, Spanish and UK medicines regulators looked again at the claim that it causes autism. They found no evidence that it does. The advice has not changed: take it only when you need it, at the lowest dose that works, for the shortest time.
- Paracetamol (called acetaminophen or Tylenol in the US) is the usual first choice for pain or fever in pregnancy.
- The EMA, the Spanish agency AEMPS and the UK MHRA found no evidence that it causes autism.
- In the US, the FDA began a label change in 2025, but said a causal link has not been established.
- Untreated fever and strong pain carry their own risks for the baby.
- Avoid ibuprofen in pregnancy unless a doctor advises it, especially from 20 weeks.
Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).
For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.
Is paracetamol safe in pregnancy?
For most pregnant women, yes, when taken as the leaflet says. The NHS calls it usually the best painkiller to use in pregnancy. It says paracetamol is commonly taken in pregnancy and does not harm your baby.
The Spanish medicines agency, AEMPS, gives the same advice. Use it when there is a real need, at the lowest dose that works, for the shortest time and as rarely as possible. That advice has not changed. The aim is simple: treat the pain or fever you have, not take it just in case.
What happened with the 2025 autism claim?
On 22 September 2025 the US government suggested a link between paracetamol in pregnancy and autism. The FDA began changing the US label to mention a possible association with autism and ADHD. AEMPS notes that the FDA itself said a causal link has not been established.
Other regulators reviewed the evidence within days:
- EMA (European Union), 23 September 2025. It found no evidence that paracetamol in pregnancy causes autism. It called paracetamol an important option for pain and fever. Its January 2026 update cites a 2026 meta-analysis. That review found no higher risk of autism, ADHD or intellectual disability at recommended doses.
- AEMPS (Spain), 23 September 2025. It found no evidence of a causal link with autism or other development problems. Its advice did not change.
- MHRA (UK), 22 September 2025. It said there is no evidence that paracetamol in pregnancy causes autism. It remains the recommended pain relief when used as directed.
- ACOG (US obstetricians), 22 September 2025. It said no reputable study has shown that paracetamol, in any trimester, causes these conditions.
So the advice in Spain, the rest of Europe and the UK is the same as before.
Why did some studies find a link?
Some studies found a small link. But these studies watch what people do. They cannot prove that one thing causes another. Women who take paracetamol often have fever, infections or pain. Families also share genes and home life. All of these can affect a child's development.
A large Swedish study in JAMA in 2024 followed nearly 2.5 million children. At first it found a very small rise in risk. Then it compared brothers and sisters from the same family. The link disappeared for autism, ADHD and intellectual disability. The authors concluded that family factors likely explained the earlier findings.
ACOG also notes that the two highest-quality studies found no clear link.
Is it riskier to leave pain or fever untreated?
It can be. The MHRA warns that untreated pain and fever can pose risks to the unborn baby. AEMPS says the same. ACOG says the conditions paracetamol treats in pregnancy are far more dangerous than any theoretical risk.
So do not avoid paracetamol out of fear when you need it. If you are worried, talk to your doctor or midwife (matrona).
Pain or a fever in pregnancy and not sure what is safe to take?
You can book a video visit with a GP licensed in Spain, in English or Spanish. He checks your symptoms and your medicines, and tells you what is safe now and when you need to be seen in person.
How do I take paracetamol safely in pregnancy?
- Take it only when you need it, for pain or fever.
- Follow the leaflet (prospecto) and never take more than it says.
- Use it for the shortest time you can.
- Check the label of everything you take. Many cold and flu remedies already contain paracetamol.
- Some products mix paracetamol with other medicines, such as codeine or caffeine. Ask a pharmacist or doctor before you take these in pregnancy.
- See a doctor if the pain or fever does not get better, or if you need paracetamol often.
This guide gives no doses. Your pharmacist can explain the leaflet. Our guide to paracetamol in Spain covers brands, packs and prescription rules.
Can I take ibuprofen instead?
Usually not. The UK pregnancy medicines service, Bumps, advises against ibuprofen in pregnancy unless a doctor prescribes it. It says this matters most from 20 weeks. Later in pregnancy, ibuprofen can reduce the fluid around the baby. It can also close a key blood vessel in the baby's circulation too early.
If you took ibuprofen after 20 weeks, do not panic. Tell your midwife or doctor. Bumps says they may check the baby and the fluid with a scan.
When should I see a doctor?
See a doctor or your midwife today if:
- You have a fever. The cause needs checking, not just the temperature.
- Pain does not ease with paracetamol, or keeps coming back.
- You need paracetamol most days.
Go to urgencias or call 112 if you have taken more paracetamol than the leaflet allows, even if you feel well. Liver damage can take days to show. Also call 112 if your face, lips or throat swell, or you struggle to breathe. The Spanish Poison Information Service is on 91 562 04 20.
Talking it through with a doctor by video
Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:
- Ask how many weeks pregnant you are and what the pain or fever is like.
- Check every medicine you take, including combination products.
- Look for warning signs that need an in-person check today.
- Explain what is safe to take now, alongside your midwife and obstetric care.
He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.
A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.
See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.
This guide is general information. It does not replace the package leaflet or the advice of your doctor, midwife or pharmacist.
Frequently asked questions
Is paracetamol safe in pregnancy?
Yes, when you need it. It is the first-choice painkiller in pregnancy. Use the lowest dose that works for the shortest time, as the leaflet says.
Does paracetamol in pregnancy cause autism?
There is no evidence that it does. The EMA, AEMPS and MHRA all reached this conclusion in September 2025. A large sibling study found no link.
Why did the FDA change the US label?
In 2025 the FDA began adding a possible association with autism and ADHD. It also said a causal relationship has not been established. EU and UK advice did not change.
Can I take ibuprofen while pregnant?
Only if a doctor advises it. It is especially not advised from 20 weeks, because it can affect the baby's fluid and circulation.
Should I avoid paracetamol to be extra safe?
No. Untreated pain and fever have their own risks for the baby. Take it when you need it and talk to your doctor if you need it often.
Can I take paracetamol while breastfeeding?
Yes. The NHS says paracetamol is usually the best painkiller to take while breastfeeding.
Sources
- EMA: Use of paracetamol during pregnancy unchanged in the EU
- MHRA: Paracetamol in pregnancy remains safe, no evidence it causes autism
- NHS: Pregnancy and breastfeeding while taking paracetamol
- Ahlqvist et al., JAMA 2024: Acetaminophen in pregnancy and children's risk of autism, ADHD and intellectual disability
- Bumps (UK Teratology Information Service): Ibuprofen in pregnancy
Related guides
Medical Citations & Sources
This content is written and reviewed by a licensed physician with reference to the following official health authorities.
