As my alarm rings at 6:30 AM, I maneuver my 32-week pregnant body to a sitting position, careful not to overstrain my core as advised by experts. I make my way down the stairs, gripping the railing to ensure I don’t wake my two toddlers. These 30-45 minutes of solitude are a rare and cherished moment before the day begins.
After tending to my dog and ensuring his needs are met, I finally settle into my desk chair with coffee, water, and toast. Glancing at the calendar reminds me that my mother will soon arrive to help with the children. Given the physical toll of carrying the extra 40 pounds of pregnancy weight, lifting my 2.5-year-old and 15-month-old feels increasingly challenging.
Next to the calendar hangs the ultrasound photos from my latest scan, and I quietly hope that my husband will return from deployment before our third child arrives. I then take a deep breath and swallow my daily SSRI – a vital part of my routine for the last nine years, preparing for whatever the day may bring.
My heart sinks as I learn about a recent FDA panel discussion on the use of antidepressants during pregnancy.
The Prevalence of Maternal Mental Health Disorders
It is well-known among mothers that perinatal women face significant rates of mental health disorders. Medical organizations such as the AHA, APA, ACOG, and NCRP assert that conditions like depression, anxiety, OCD, and psychosis are primary contributors to complications during pregnancy and childbirth, impacting one in five women.
Critique of the FDA Panel
However, these critical facts seem to have been overlooked by the FDA panel that discussed SSRI usage. Under the guidance of Robert F. Kennedy Jr., known for his skepticism towards antidepressants, the meeting presented a skewed analysis, emphasizing the potential risks to fetuses while downplaying the dangers associated with untreated maternal mental health issues.
Many panelists cited a supposed connection between antidepressant use and neurocognitive disorders in children, a claim not supported by current evidence. Some even questioned the efficacy of antidepressants altogether, contradicting established research, while others lumped together depression in perinatal women as merely an emotional state and suggested doctors were coercing patients into medication.
Statistics on Medication Usage
Contrary to panelist claims, only around 8% of the estimated 14-23% of women diagnosed with maternal mental health disorders are currently on SSRIs. Many women are hesitant to continue antidepressant treatment during pregnancy, with nearly half ceasing their medication during this period.
I was first diagnosed with OCD in graduate school in 2016, reaching a personal crisis when I struggled to engage in treatment. Initially reluctant, I eventually started medication, leading to significant improvements in my quality of life.
Personal Journey with Antidepressants
After years of treatment with Zoloft and Abilify, I transitioned to Viibryd, another SSRI. Upon becoming pregnant in 2022, my psychiatrist, OB-GYN, and a maternal-fetal specialist collectively deemed my continued use of medication a low-risk decision, which I agreed to after scheduling a fetal echocardiogram to monitor my baby’s heart condition due to a slight risk associated with my meds.
In October 2022, I welcomed a healthy baby girl, but subsequently battled postpartum depression and anxiety after her difficult birth, prompting me to increase my medication dosage with my psychiatrist’s guidance.
When I unexpectedly became pregnant again ten months later, I felt no inclination to discontinue my medication. Now, as I approach my third delivery in three years, the thought of stopping has never entered my mind.
Concerns Over Misinformation
The FDA panel failed to acknowledge the rising skepticism around medications, including vaccines, particularly prevalent among women. The influence of wellness culture, amplified by the “crunchy moms” of the MAHA movement, has produced apprehension towards medical interventions.
This misrepresentation fosters fear in an already vulnerable demographic. Should warnings about antidepressant use during pregnancy be enforced, expectant mothers could find themselves facing even greater obstacles to essential treatment.
Ironically, while several panelists expressed an intention to educate women about the risks of SSRIs, no studies mentioned during the discussion were available on the FDA’s official webpage, undermining the credibility of the dialogue.
Only Dr. Kay Roussos-Ross acknowledged the potential advantages of antidepressants, noting that suicide remains the leading cause of maternal mortality in the perinatal period and highlighting these medications as vital in combating this issue.
The Importance of Mental Health Treatment
Antidepressants may not be the perfect solution for everyone, but they often represent a first-line treatment for mental health conditions, particularly when other options are limited. For me, using my SSRI enables me to manage my emotions effectively, allowing me to meet the demands of being a working parent and military spouse.
The mild side effects associated with my medication are negligible compared to the serious risks posed by untreated maternal mental health disorders, including low birth weight, preterm birth, and heightened risks of maternal and infant mortality.
During the panel, Dr. Roussos-Ross stressed the necessity of prioritizing the well-being of both mother and child, countering the harmful myth that maternal needs should always be sacrificed. Unfortunately, many women with maternal depression remain untreated due to stigma and lack of awareness, with less than 16% receiving the help they need.
Empowerment Through Choice
Mothers deserve to be equipped with accurate, evidence-based information to make informed decisions alongside their healthcare providers. The intention to take an SSRI during pregnancy should not equate to being a “bad mom” or failing one’s child.
I am thankful for the freedom to continue my SSRI throughout my pregnancies and fear the potential limitations the FDA panel’s findings may impose. Women like me must have access to necessary treatments, as maintaining our mental health is crucial for caring for our families.
