On the heels of the recent White House announcement about acetaminophen (Tylenol) in pregnancy, we -- as reproductive psychiatrists who focus on the well-being of pregnant patients throughout preconception, pregnancy, and postpartum -- can attest that guilt, self-blame, and panic has set in. [ MEDPAGE Today]

Just the other day, a patient at 26 weeks of pregnancy messaged us that she is now "totally freaked out" about all medications during pregnancy. Even though her obsessive compulsive disorder is severe, even incapacitating at times, she still wants to stop taking every medication she is on: "Maybe I just shouldn't take any medications at all. I should just be strong enough to get through anything. I just wouldn't be able to live with myself if anything went wrong. It would be all my fault."

It wasn't just the degree of anxiety that was striking about her message. It was that guilt and self-blame permeated every word.

Last week, the White House delivered a stunning claim: acetaminophen use in pregnancy increases the risk of autism in children. Officials pledged swift action: new FDA labels, physician notices, and federal research initiatives. Yet, much of the "evidence" for any potential link comes from observational studies showing correlation, not causation. And sibling-controlled studies have shown those associations disappear once confounding variables are accounted for. Further, it doesn't take into account the potential harms of not treating important medical conditions.

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