Opinion
Clare Moriarty: Trump’s ‘tough it out’ message to pregnant women is dangerous
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In a nervously awaited press conference at the White House on Monday, US president Donald Trump, alongside his secretary of health and human services Robert F Kennedy jnr and Mehmet Oz, head of the Centers for Medicare and Medicaid, made their “big announcement” on autism.
After a characteristically meandering prologue from Trump, the two “important findings” were delivered by Kennedy and colleagues. First, they drew a causal link between use of acetaminophen (paracetamol to us) and autism, declaring plans to instruct the FDA to “initiate a safety label change”. Second, they identified leucovorin (folinic acid) as an “exciting therapy” for children with existing diagnoses.
Much has already been written describing the whole gamut of scientific and ethical issues raised by Monday’s announcements. The phrases “correlation doesn’t imply causation” and “ableism” figure prominently.
Trump, Kennedy and their Maha (Make America Healthy Again) initiative have become central to discussions of contemporary hostility to science. Alongside the infamous cuts to American research infrastructure by the Department of Government Efficiency (Doge), Kennedy’s recent declaration that “trusting the experts is not a feature of either a science or democracy” was a sign of his complete lack of regard for scientific method. Though it certainly requires critical thinking and dissent, a scientific approach also depends on trust. At certain levels of complexity, we can’t all check each other’s work and it’s impractical to instruct people to “do their own research”.
Numerous autism advocacy groups have also signalled concerns over a shift to a “root causes and prevention” approach to autism, in place of one focused on support. “Autism is not a disease to be cured,” the Irish charity AsIAm said in a statement.
Kennedy briefly noted the “complex”, “multifactorial” aetiology of autism before reaching for his favoured association between vaccines and autism. But whatever limited restraint might have been exercised in his framing of the announcements was exploded by Trump’s bookending bloviations.
The press conference was profoundly anti-science, as evidenced by the swift litany of press releases decrying the statements from international medical professional associations, autism expert groups and public health agencies. It was also deeply anti-woman and slotted into the Maha framework of thinking about women’s health.
Paracetamol is the only pharmaceutical pain relief available to most pregnant women. It’s also crucial for treating fever. The American College of Obstetricians and Gynaecologists says “acetaminophen is one of the few options available to pregnant patients to treat pain and fever … Maternal fever, headaches as an early sign of pre-eclampsia, and pain are all managed with the therapeutic use of acetaminophen … The conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks and can create severe morbidity and mortality for the pregnant person and the foetus.”
Reading transcripts of Trump’s speech and trying to summarise the propositions is a reminder of the utter chaos of his thought. Perhaps he’d been briefed on the need for caution around fever, because he mentioned cases where paracetamol might be necessary: “That’s, for instance, in cases of extremely high fever, that you feel you can’t tough it out.”
That “tough it out” rhetoric, which he used repeatedly, is telling. “If you can’t tough it out, if you can’t do it, that’s what you’re going to have to do. You’ll take a Tylenol, but it’ll be very sparingly. It can be something that’s very dangerous to the woman’s health, in other words, a fever that’s very, very dangerous and ideally a doctor’s decision because I think you shouldn’t take it and you shouldn’t take it during the entire pregnancy.”
This “tough it out” presentation of fever and pain in pregnancy as something to be weathered – something that, if you grit your teeth will vanish unassisted – is emblematic of a mood of talking about women’s pain (especially in pregnancy) as barely medically salient. It trivialises women’s suffering, endangers their welfare, and carves a dangerous wedge between women and their healthcare supports at a critical time.
Dr Anne Dee, president of the Irish Medical Organisation, emphasised the issue of eroding public confidence in a strong rebuke of the claims: “There is no scientific evidence to suggest that paracetamol usage while pregnant is linked to autism in children, and this assertion does nothing but undermine pregnant women’s confidence in the medical system for no justifiable reason at a particularly vulnerable time in their lives.”
It’s not very surprising to see such careless suggestions that women’s healthcare choices in pregnancy explained their children’s neurodivergence come from an administration that has shown continual disdain for women. Alongside the surge of “tradwife” influencer culture, which instructs women to submit to husbands and “lean in” to completely economic disempowerment, social movements have sprung up stigmatising any trust in medicine (often styled “interventions” to the course of nature). A new breed of wellness influencers instructs us to ignore medical advice, discontinue medications and heal at home – the same old snake oil, now repackaged as empowerment against dogma.
Equally shameful was Kennedy’s chiding co-opting of the “believe all women” slogan to describe the “gaslighting and marginalising” of a very particular subset of women: those who believe vaccines impacted their babies’ neurologic development. This was especially galling in the context of the claim that pregnant women’s failure to “tough it out” was responsible for their children’s health outcomes – and even more so when the children in question are so often stigmatised and pathologised by this same movement.
[ What is behind Trump’s claims that painkillers increase the risk of autism?Opens in new window ]
Medical and scientific institutions must continue to counter these narratives and pursue reproductive and paediatric healthcare that sustains public trust. Women’s healthcare may well be the new front line in the fight to retain trust in science and institutions.
Dr Clare Moriarty is a postdoctoral researcher working at Trinity Research in Social Sciences in Trinity College Dublin
