TRANSCRIPT

23 SEPTEMBER 2025

Paracetamol safe for use during pregnancy

AMA Queensland Immediate Past President Dr Maria Boulton spoke to ABC Southern Queensland about paracetamol remaining a Category A drug, with no evidence to prove its use during pregnancy causes autism. 

Transcript: AMA Queensland Immediate Past President, Dr Maria Boulton, ABC Southern Queensland, Drive with Caitlin Sawrey, Tuesday 23 September 2025

Subject: Paracetamol and Autism

CAITLIN SAWREY: Taking any medication while you're pregnant needs to be considered carefully and under the supervision of your doctor. But simple pain relief medication like paracetamol has long been considered safe for pregnant women to use if they really need it. Yesterday, the US President Donald Trump made a big announcement that he said would be mind-blowing, and it was this: that there's a link between women who take paracetamol while they're pregnant and autism in children. The US administration said its use during pregnancy should be limited. Now that's a big claim and it's had our Federal health minister turning to the TGA for advice. Dr Maria Boulton is a GP and Immediate Past President of AMA Queensland. Good afternoon, Maria.

DR MARIA BOULTON: Good afternoon.

CAITLIN SAWREY: Should pregnant women throw their paracetamol away right now and avoid taking it at all costs, even if they've got a bad headache or a temperature from having a virus? 

DR MARIA BOULTON: No, absolutely not. As far as the scientific advice and the professional advice from the TGA and the College of Obstetricians is that nothing really has changed. The TGA actually released a statement in response to President Trump's statement saying that paracetamol is still considered the safest medication to use when there is a fever or pain in pregnancy. It remains a Category A drug, which means it has been used by many women without any issues to their foetus. The statement also says that there is absolutely no evidence that paracetamol causes autism or ADHD. I think at the end of the day, pregnancy is a wonderful time. But I look after pregnant women as any other GP does, and I know that it is a time of anxiety. The advice that I've always given my patients is before you take anything, please check, make sure it's safe. That goes with every medication. But as far as I'm concerned, there is absolutely no robust evidence of what President Trump is alleging. 

CAITLIN SAWREY: So paracetamol fits into this Category A medicine. What does that mean? Can you explain what that means? 

DR MARIA BOULTON: Medications are categorised according to their safety in pregnancy. And Category A medications have been studied for a long time and basically they're considered safe for use in pregnancy. It means that it has been taken by many pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other harmful effects on the foetus having been observed. The other thing is that there's really no option. And when you talk about pregnant women who have fevers or pain, the fever in itself can be harmful to a pregnancy. The safest option at the moment is to treat it with paracetamol if it's appropriate, according to what's happening with that woman.  Some women may turn to ibuprofen or aspirin but once again, those medications are not as safe and they should only be taken if prescribed by a doctor. 

CAITLIN SAWREY: If we have all this data saying that paracetamol is safe, where does this claim that taking Tylenol, as it's known in the US, when you're pregnant, can lead to autism in children? Where does that idea come from?

DR MARIA BOULTON: These ideas come up from time to time, and in a world full of social media, there is a lot of misinformation. From time to time, you see stories about different things causing different things. Sometimes they're just associations. Sometimes it's because those things are diagnosed a similar time, but there's actually no proven effect. There have been a couple of studies that have shown maybe an association between paracetamol and autism, but there's many, more studies that have shown absolutely no association and no causation. There was a very good study published in the JAMA last year with 2.5 million children from Sweden. It was a very robust study and it actually showed absolutely no causation, and that's the study a lot of people will quote as it's a really robust study. When it comes to studies, you have to look at how well it's done and whether it also allows for confounding factors. With paracetamol you have to think about whether it’s the paracetamol or is it the fact that those women were taking paracetamol because they had a fever or because they had an infection? Could that have been a confounding factor? And in the study that President Trump seems to be talking about, there's a lot of concern that the confounding factors weren't looked into properly. 

CAITLIN SAWREY: I understand Robert Kennedy has been looking into autism since early in the year. How do you think that's kind of leading to yesterday's claim? And what do you think this means for people with autism?

DR MARIA BOULTON: At the end of the day, we must remember that many of us have family members who have autism or are autistic. And for us, it's not an actual disease. For others, they need a lot of support. It's really important that rather than looking at studies that don't actually show anything or actually not done properly, that we focus our energies into supporting those people who need our support. I think the other important thing is that pregnancy is a wonderful time, but it's a time when that mother's guilt starts to set in, and this is terrible because we just don't want people to feel guilty. We know that the causes of autism are multifactorial. We know that there's a huge genetic component. We know that some people do struggle with getting some supports for their family members. And above all, they need that support. Some of them will need early intervention. What we don't need is these claims that are erroneous, that just create anxiety, guilt and confusion at a time when all we need is support. Pregnant women need good advice. And I think if you're pregnant and you're listening to all the stuff on the media today, please go and consult with your GP. Please go and consult with your obstetrician and be reassured by the fact that the TGA, in response to all of this, released a statement. And it's a very clear statement that basically nothing has changed. Paracetamol is still considered a Category A. 

CAITLIN SAWREY: So it's safe if you have a headache or a fever and you're pregnant, you're fine to take paracetamol. That's the takeaway here. 

DR MARIA BOULTON: I think the best scenario is to consult with your medical professional, and that's what I say to my patients. That's what I've been saying to them for the 25 years that I've been caring for pregnant women. It's actually in the handout I give them: before taking a medication, always ask your healthcare professional whether it's safe. That hasn't changed. And of course women won't take medication if they don't need it either. It's not like we're taking paracetamol like lollies. So always check with any medication that you take, that it's safe. Rest assured that the evidence has not changed from yesterday to today, that it remains the same, and that, above all, make sure that you're supported through that pregnancy. I really feel for those families who are being made anxious about all of this. My heart goes out to them, but just make sure that please, reach out to your medical professional.

CAITLIN SAWREY: Absolutely. Thank you so much for your time, Maria. 

DR MARIA BOULTON: Thank you.