My Midwife Told Me To Take Tylenol

Shortly after we found out I was pregnant this fall, I started to have intense shoulder and neck pain.

At first, I thought it was due to stress combined with relaxin, a hormone that relaxes muscles and loosens joints enough to contribute to back pain even during early pregnancy. The pain seemed to fade over a week or so, but shortly came back with a vengeance, so I did what all expectant mothers do in such circumstances: I Googled to see what terrible thing might be going wrong with my pregnancy.

Sure enough, I discovered that ectopic pregnancy can create intense shoulder pain. I called my provider’s Babyline and explained my symptoms, and she advised me to come in to rule out ectopic pregnancy. To get seen quickly, I took whichever midwife was available soonest, grateful for the opportunity to hopefully ease my and my husband’s minds.

Fortunately, as I described my particular pain, she reassured me that she didn’t think it was at all likely that it was an ectopic pregnancy. It was a regular old neck ache, which was actually wonderful news. The twist came when she directly told me, more than once, to take acetaminophen. Not one option among many, not “if it gets unbearable, you can use Tylenol,” and certainly not “I know the research is developing right now, but if you feel comfortable with it, you can take Tylenol.” No, she just simply told me, flat out, to take acetaminophen.

Personally, even before the recent controversy over Tylenol, I am someone who only uses any medication as a complete last resort. In this case, it actually had not yet even crossed my mind to take any pain medication for the pain I was experiencing, even though at its worst it did feel somewhat debilitating.

So, unprompted by my concerns or complaints, without me asking for medication recommendations or saying I wasn’t able to cope, she went out of her way to say, more than once, that I should take acetaminophen while pregnant.

Whether or not Tylenol use during pregnancy conclusively causes autism is not the point; the point is that recent studies, like this one and this one, suggest it might. The fact is, the FDA is currently changing the labels on acetaminophen 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.” If I’m not going to risk a glass of wine or some runny eggs or even certain herbal teas while pregnant, why would I risk Tylenol for neck pain, knowing this?

While it might be tempting to give the benefit of the doubt and assume that this particular midwife hadn’t heard the news, that’s a little too much of a stretch knowing that almost immediately after the press conference on acetaminophen’s possible effects on unborn children, the controversy went viral online. TikTok was swamped with videos of nurses and doctors telling pregnant patients to continue using Tylenol. Then, we saw a disturbing number of pregnant women post videos of themselves taking Tylenol, seemingly just to prove their hatred of Trump. In addition to the internet’s obsession with this issue, the FDA also issued an official letter to alert physicians nationwide.

Where is the future of medicine heading if politics are more important to practitioners than their own patients?

With this sort of cultural and clinical prominence, it leaves little room to believe anything other than that she specifically wanted to contradict the developing science behind the FDA’s updated information on acetaminophen use in pregnancy. And, since there is no clear reason anyone would do this for medical purposes (again, I had no high fever, just a neck and back ache, and wasn’t asking for medication), the only remaining reason would be for the political statement it makes. Not only that, but making that statement was somehow more important than the safety of my unborn child or my ability to make educated decisions for myself and my baby.

It seems that the COVID era has taught some health care professionals nothing about the importance of trust in medicine. You would think that the sharp increase in “vaccine hesitancy” since 2020 would have made them realize that what people want is an open conversation about the actual and current science behind their medical options, not simply to take a stranger at their word, no matter what degree or title they may hold. I can’t help but be reminded of the shift of those who love to “follow the science” from vaccine-skeptical, when it was Trump’s COVID vaccine, to religiously pro-vaccine, when it was Biden’s. It shouldn’t matter who is president when new clinical information or resources come out; it should simply matter what the most up-to-date research reveals is healthy and prudent for patients.

Let’s return to me in the midwife’s room. In pain, pregnant, and rushing there and back to take care of my two other little ones, I had to make a decision: Do I question this midwife I’ve never met and will probably never see again on her recommendation? Do I push back to prove a point of my own, risking an uncomfortable interaction and some snarky notes on my chart? And would it affect my relationship with my regular midwife? Could it affect how I’m treated when I say no to other interventions, or affect how I feel or how I’m treated when it comes time to give birth?

In the aftermath of Charlie Kirk’s tragic public assassination, videos have surfaced of health care professionals celebrating his murder. One intensive care nurse from Michigan said Kirk “got the day he deserved,” while a doctor from New Jersey allegedly celebrated in front of staff and patients, also saying that Kirk deserved his assassination. A psychologist from Australia cheered on his death in particularly gruesome fashion in a TikTok video she felt confident sharing online for the world to see. If some nurses, doctors, and other health care professionals don’t think conservative people, or Christian people, or anyone who thinks differently than they do, deserve to live, then how can we trust them to help those people be healthy in the first place? If I spoke up at that moment about Tylenol, would I be labeled as MAGA and considered subhuman?

We saw a preview of this divisive mentality in health care professionals during the pandemic, when various doctors, nurses, and other care providers publicly suggested that they would refuse care to unvaccinated patients or, at the very least, openly prioritize patients who had gotten the shot. As I was also pregnant back when the vaccine became publicly available, I, like many other women in my position, chose not to get the shot due to the obviously limited research available on the vaccine’s safety for babies in utero. For me, this led to more than one lecture, including one from a hospital pediatrician who must have seen my chart and went out of his way to confront me and my husband during our hospital stay after I gave birth. Luckily, I was never refused care, but I did feel like I was constantly playing defense.

If I spoke up at that moment about Tylenol, would I be labeled as MAGA and considered subhuman?

Don’t get me wrong—I do not mean to equate letting patients die (or hoping that they do) based on their political beliefs or their vaccination status with recommending Tylenol for pain relief in pregnancy. But these things exist on a spectrum, both aspects of the atmosphere of violence and anger toward people who make different life and health choices on the one hand, and the mistrust that that creates in patients on the other hand. As a professional voice coach, I’ve found myself perfectly capable of helping clients reach their vocal goals even when I could not be more different than them as a person. Shouldn’t we all, in the far more vulnerable and life-threatening environment of medicine and health care, be able to expect the same sort of respect?

From the various forms of birth control to the COVID shot and now to Tylenol, we are begging to be trusted to make our own informed decisions—not coerced into medical choices based on our practitioner’s politics, personal beliefs, or personal agenda. We want to know the research; we want an environment where questions are welcomed and where different perspectives are taken into consideration. It takes an average of 17 years for the most recent, groundbreaking research to actually reach your interactions with your doctor. What if we could bridge this gap, even slightly, with open conversation?

So maybe I should have said something to that midwife. Maybe I should have been the one to risk tension to work toward a human connection and a possibly productive conversation. But I didn’t. I nodded and smiled, went home, and didn’t take the Tylenol. Still, the question remains: Where is the future of medicine heading if politics are more important to practitioners than their own patients? Where is the future of medicine heading if patients feel they could be risking their safety by asking questions about their care? It’s past time we agree that people, no matter their differing beliefs, should take priority over ideologies. The health of our nation, in more ways than one, depends on it.