Consider the case of a women who is 3 months pregnant and develops a high and persistent fever (by no means a rare event). Her doctor diagnoses a strep throat and treats her with antibiotics. For lowering her temperature, he would normally have advised paracetamol (acetaminophen). After this was pronounced prohibitively dangerous, he has 3 options:
- Give no medicine for the fever.
- Give Aspirin.
- Give ibuprofen.
What are the risks involved in these three options?
1. Give no medicine for the fever
High or sustained fever, especially in the first trimester (which the patient is nearing the end of or just finished), has been associated with an increased risk of certain birth defects, including neural tube defects, heart defects, and cleft lip/palate.
2. Give Aspirin
The use of Aspirin during pregnancy, especially at higher doses (not the low dose often used for preeclampsia prevention), carries the following risks:
- Higher doses of aspirin during early pregnancy raise the risk of pregnancy loss and congenital defects.
- Higher doses of aspirin are also associated with premature closure of the ductus arteriosus (a fetal heart vessel), fetal kidney problems, and increased bleeding risk for both mother and baby.
Low-dose aspirin is considered safe but may not affect the fever.
3. Give Ibuprofen
- Some studies suggest an increased risk of miscarriage, if taken around conception or over a long period, though evidence is conflicting.
- Ibuprofen is contraindicated in the third trimester (after 28 weeks) due to the risk of fetal renal dysfunction, premature closure of the ductus arteriosus or inhibition of uterine contractions.
What are the consequences?
One can extrapolate that an adherence to a “no paracetamol” policy to treat fever in pregnancy would likely have the following effects in the US:
- Over a thousand additional severe birth defects per year that might have been prevented by safely treating a high fever, especially in the first trimester.
- Many thousands of additional cases of preterm labor/delivery caused by untreated maternal fever later in pregnancy.
- A significant increase in the use of the riskier medicines such as ibuprofen or Aspirin which are associated with fetal risks, leading to hundreds of new cases of fetal kidney and cardiac issues.
In other words, persuading pregnant women to forgo the safest, most effective fever reducer would cause thousands of severe, preventable fetal adverse outcomes per year. This would far outweigh the unproven or even disproven risk of autism from short-term, appropriate paracetamol use.
5 Responses to The ‘Acetaminophen Debacle’: Trump and RFKJr have blood on their hands … and here is why
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This acetaminophen debacle will certainly have consequences for pregnant women and their children.
But Trump will have (and already has) more blood of innocents on his hands:
– Tens or even hundreds of thousands of the poorest people who were dependent on USAID and the PEPFAR program will die.
– Trump’s attack on US healthcare programs will cost thousands of lives annually, simply because low-income people can’t afford healthcare insurance and healthcare treatments any more, with insurance premiums expected to double or even triple next year. This is a direct consequence of Trump’s Big Billionaire Bonus Bill, where the richest people in the US get $4 trillion in tax breaks, paid for by the poorest people in the US.
– Trump’s consumer taxes (a.k.a. ‘tariffs’) will increase prices and make life much harder for especially low-income people and small business owners. Health problems and suicides among these people are expected to rise sharply.
– And of course Trump has killed at least 20 people in cold blood off the coast of Venezuela.
@richardrasker
And not to mention the health harms of burning fossil fuels, along with climate change that affects us all given Trumps views on these important issues.
https://www.theguardian.com/environment/2025/sep/24/fossil-fuel-burning-threat-health-16bn-people-data-shows
more on the subject:
https://www.bmj.com/content/391/bmj-2025-088141?utm_source=etoc&utm_medium=email&utm_campaign=tbmj&utm_content=weekly&utm_term=20251121&nbd_source=adestra&nbd=fb3117a605ac195fe6685573823b55c61945f2642b46593fcc1ba966b7dfb14e&uaa_id=fb3117a605ac195fe6685573823b55c61945f2642b46593fcc1ba966b7dfb14e&utm_campaign=This%20week%20in%20The%20BMJ&utm_medium=email&utm_source=adestra
JUST PUBLISHED IN THE LANCET: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00243-6/fulltext?dgcid=raven_jbs_aip_email
On the subject of ‘blood on their hands’:
https://edition.cnn.com/2026/02/04/world/lancet-usaid-global-aid-cuts-intl
“… a new study published in The Lancet medical journal aims to quantify the human toll of those budget decisions – projecting that global aid cuts could lead to at least 9.4 million additional deaths by 2030, if the current funding trend continues. About 2.5 million of those deaths are projected to be children under the age of 5.”
and
” ‘People are dying already’
The Center for Global Development’s own analysis of the USAID cuts alone found that the decline in current spending may have led to between 500,000 to 1,000,000 lives lost in 2025 compared to previous years.”
Of course, those dead or at risk of dying are in overwhelming majority poor and non-white.
But what about Americans? Surely they profit from Trump’s “America First” policies?
Wrong:
https://www.forbes.com/sites/brucelee/2021/02/11/report-trump-associated-with-461000-deaths-in-2018-others-deserve-blame-though/
In his first term, hundreds of thousands of Americans died as a result of Trump’s stupidity – of course again mostly poor and/or non-white Americans.
And things are only set to get much worse in this second term, with the demolition of Medicaid, domestic food and health support programs and education, while prioritizing huge corporate profits over people’s health and well-being.
So when he finally kicks the bucket, the Trump regime’s death toll may well be up there with what Stalin and Mao achieved.