Trump’s paracetamol warning is misogyny masquerading as evidence-based medicine

It’s a strange day when the President of the United States of America feels the need to start giving medical advice to expectant mothers.

Not content with just appointing his cronies the task of ripping up one of the most significant public health advances of the past 200 years, namely childhood vaccination, Donald Trump has now offered his opinion about paracetamol as being “associated with a very increased risk of autism”.

Let’s all just take a deep breath and try to stay calm while we consider this new information.

This advice is coming from the same person who thought ingestion of bleach might work to treat COVID-19 in the body, since it was effective at killing the virus in-vitro.

After airing his views on this matter, “pointing to his head, Mr Trump went on: ‘I’m not a doctor. But I’m, like, a person that has a good you-know-what’.”

Attempts to control women and their bodies are nothing new, especially in Trump’s America. Pouncing on scientific evidence that is not necessarily accurate or validated, in order to make pregnant women feel guilty about taking medication for pain or fever because they can’t “tough it out”, is another form of medical misogyny that needs to be called out.

The state of being pregnant is an amazing thing, but it comes with some weird and not-so-wonderful effects. When pregnant, your body is most definitely no longer your own — not only due to the growing fetus inside, but also due to the attitudes and beliefs of the society around you.

The first thing that happened to me when I got pregnant was that 20 years of being vegetarian went straight out the window: suddenly all I wanted to eat was ham and eggs, followed by a stop at McDonalds for a cheeseburger. It felt like my body had been taken over by a tiny but determined carnivore.

Along with sudden cravings came a whole list of rules about what I was or wasn’t allowed to consume. I remember my stepmother scoffing at me as I perused the lunch menu at a fancy restaurant for something that I could safely eat. Seafood? Too much mercury. Soft cheese, pre-made salads? Listeria.

“Rubbish,” she said. “We ate all those things in my day and nothing bad ever happened.”

At 16 weeks I had torrential epistaxis from both nostrils — likely due to a pregnancy-related nasal polyp — and twice landed in the local hospital’s emergency department, where various methods were used to stem the gushing flow of blood.

I noticed too late that the bottle of local anaesthetic spray they used (without success) to numb my nose before stuffing it full of packing had written on the side: “Do not use in pregnancy”.

Nasal packing is excruciatingly painful, but I freaked out and refused to let them use the spray again, which turned out to be a rather bad move as I had to endure repacking several times, as my nose continued to bleed despite every attempt to make it stop.

It turns out that many medications have “Not recommended for use in pregnancy” in the product information or emblazoned on their packaging, when in reality they are perfectly safe. We just haven’t formally tested them on pregnant people because, well, ethics.

The spectres of diethylstilboestrol and thalidomide still hang over us despite their use in pregnancy being banned 50 and 60 years ago respectively.

Of course, nobody wants their children to have health problems or challenges that might have been avoidable.

Growing a baby inside yourself is hard enough without adding all the external pressures to do everything right. There are so many dos and don’ts, with the added implication that if something goes wrong with the pregnancy or baby, it must be the mother’s fault in some way.

These pressures on modern parents are probably behind the rise of “helicopter parenting”, where overanxious parents micromanage their offspring in the hope of avoiding any sort of problems.

But this approach certainly hasn’t reduced the rates of autism or mental health problems in the generations that have followed. If anything, it would seem to have had the opposite effect.

Pregnant women the world over already have enough to deal with, from unsolicited dietary advice to unwanted pats on the belly, from scare tactics about medication to speculation about vaccinations causing children harm.

Now they have to “tough it out” with pain or fever during pregnancy, for fear that their baby will end up with autism, just because Donald Trump said so?

Doctors can get into quite a lot of trouble for expressing their political opinions. If only the same were true for politicians expressing their medical opinions, especially when it turns out to be fake news.

Dr Rachel Glasson is a GP in Sydney, NSW.

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