Is acetaminophen safe during pregnancy?

What does the evidence say about acetaminophen during pregnancy?

1. Large studies over decades have not shown that occasional or short-term acetaminophen use during pregnancy raises the chance of birth defects. 1
2. Acetaminophen remains one of the few pain relievers considered safe during pregnancy, even though some newer studies have raised questions that haven't changed medical guidance. 2
3. Letting a high fever go untreated carries its own risks to the baby, including neural tube defects, which is a key reason doctors recommend bringing a fever down promptly. 3
4. The daily limit is 4,000 mg from all sources combined, and many cold medicines already contain acetaminophen, so it's worth adding up everything you're taking. 4
5. Some studies have looked at a possible link to certain neurodevelopmental outcomes, but they haven't proven acetaminophen causes them, and medical guidance still supports using it under your provider's direction when needed. 1

Is acetaminophen safe in each trimester?

• First trimester. Acetaminophen is commonly used in the first trimester for fever and pain. Bringing a fever down matters too, since a high fever left alone carries its own risks.
• Second trimester. Same approach here: take the lowest dose that helps, for the shortest time, and check in with your provider.
• Third trimester. Still the go-to pain reliever in the third trimester. Ibuprofen and other NSAIDs become more restricted after about 20 weeks.