Your doctor or midwife has access to your full medical history and can weigh the actual risk for you specifically - that context matters way more than general internet takes. ACOG and most major health bodies still consider occasional acetaminophen use during pregnancy to be relatively safe when you need it, but the newer research about potential effects on fetal reproductive development is real and worth discussing rather than ignoring.
The practical thing nobody seems to mention: keep a pain/symptom log before you talk to your healthcare provider. Note what triggered the headache or pain, how long it lasted, what you tried first (rest, ice, whatever), and how bad it actually was on a scale. This gives your doctor real data instead of "I had some headaches" and helps them figure out whether you actually need pain relief or if there's a pattern you could address differently - like dehydration, stress, or posture issues that might be fixable without medication at all.
The uncertainty here is kind of the whole point. We're not talking about something definitively dangerous, but we're also not talking about something risk-free. That gap is exactly why this needs to be a conversation with someone who knows your pregnancy, your medical situation, and what alternatives make sense for you - not a yes/no answer from the internet.