Lori Falce: What's left for pregnant women?

“Take two aspirin, and call me in the morning” is a cliché for a reason.

It is the standard, trite advice you expected from your doctor about 100 years ago. It meant to just relax, take these two innocuous tablets for your headache, and get some sleep, the idea being you wouldn’t even have to talk to your doctor the next day. It was frequently the directions given to women assumed to be anxious or overreacting.

The advice was so ubiquitous, it was the title of a “story of aspirin” published by the National Library of Medicine celebrating the drug’s anniversary in 1959.

Ironically, 1959 is when aspirin’s reign as the go-to wonder drug would start to change. Acetaminophen was introduced in 1955. Branded as Tylenol, it was acquired by Johnson & Johnson in 1959 and marketed as a safer alternative to aspirin.

Why? Because while aspirin has some remarkable pros, like thinning blood to help with cardiac care, those are also its cons. Thin blood means easy bleeding. It is rough on the stomach, too.

These are some reasons that pregnant women can’t take those two aspirin and give their obstetrician a call tomorrow. A doctor might prescribe low-dose aspirin for specific, monitored conditions, but regular doses are not recommended for multiple reasons. Ibuprofen and naproxen are similarly off the table.

But acetaminophen has been the one refuge women had for pain and fever in pregnancy, at least until this week’s advice from the White House and Health and Human Services Secretary Robert F. Kennedy Jr. They suggested a link between the over-the-counter medicine and autism — a link not supported by evidence.

The idea might not seem dangerous to much more than Johnson & Johnson spinoff company Kenvue’s stock price, which fell after President Donald Trump’s announcement Monday. But there is more to it.

Pregnant women experience pain. A lot of pain. Your ligaments strain, your bones move, and that’s not even considering the literal person pushing around inside your abdomen. Because of relaxin, a hormone that facilitates that movement, some injuries, like sprains, become more possible. Because your center of gravity shifts, you might fall or bump into things.

Pain can create stress, which isn’t great for an expectant mother. It can up your blood pressure. That might mean premature birth or prompt a cesarean section.

Fevers among pregnant women don’t just affect the woman. They affect the fetus. They can mean miscarriages or stillbirths. That National Library of Medicine notes an increased possibility of neural tube defects like spina bifida and anencephaly.

If you believe these are not things that pregnant women will obsess about, you have never been a pregnant woman. There is nothing that could go wrong that doesn’t prance through the pregnant brain and put on a well-choreographed nightmare with very convincing special effects.

If there is a way for a mother to blame herself for something that hasn’t happened to her child yet, she will. If something does happen to that child, she will never stop blaming herself.

And this week, the president and our highest-ranking health official told women that the only thing they can take for pain and illness while pregnant is causing an epidemic of autism, with nothing to back it up.

I’d like to say this is all a fever dream, and that we just need to relax, take a breath and get a good night’s sleep. But the Centers for Disease Control and Prevention has changed the recommendations on its website, cautioning against acetaminophen. So there’s nothing we can all take two of and call someone in the morning.