When my alarm sounds at 6:30, I roll my 32-week pregnant body onto its side and use my arms to push myself up to a sitting position, as the experts recommend, so that I don\u2019t overly strain my core muscles. I plod down the stairs, gripping the rail to lighten my steps so as not to wake my two toddlers. The following 30-45 minutes of alone time are a treasured commodity. <\/p>\n
After letting the dog out and feeding him (because even with the kids asleep, I still have another creature\u2019s needs to consider before my own), I settle into my desk chair with my coffee, water and toast. I glance at the calendar \u2015 just two more weeks until my mom flies in town to help with the kids. Changing and lifting my 2.5-year-old and 15-month-old had begun to feel like an Olympic sport with the 40 pounds of extra weight I\u2019d been carrying. <\/p>\n
Next to my calendar hangs the ultrasound photos from my most recent scan. I say a silent prayer that my husband will get home from deployment before baby No. 3 makes his debut. <\/p>\n
And then, I pop one of my precious pink pills into my mouth \u2015 my SSRI, which has been part of my morning routine for the last nine years, and I brace myself for the long day ahead.<\/p>\n
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Before heading back upstairs to get the kids, my heart skips a beat when I learn of the Food and Drug Administration\u2019s recent panel on antidepressant use during pregnancy<\/a>. <\/p>\n
It will come as no surprise to mothers that perinatal women experience high rates of mental health disorders<\/a>. In fact, medical organizations like the AHA<\/a>, APA<\/a>, ACOG<\/a>, and NCRP<\/a> agree that maternal mental health disorders \u2015 including depression, anxiety, OCD and psychosis \u2015 are the leading cause of complications during pregnancy, childbirth, and the postpartum period, affecting one in five women.<\/p>\n
But these facts were sorely overlooked during the FDA panel\u2019s discussion on SSRI use during pregnancy. With a known antidepressant conspiracist like Robert F. Kennedy Jr.<\/a> overseeing the FDA, the misrepresentation of facts is par for the course.<\/p>\n
The panel, made up of primarily academic professors and only one practitioner who actively treats pregnant patients<\/a>, exaggerated the risks of antidepressants to the fetus while diminishing the risks of untreated depression and anxiety to mother and child. Several panelists mentioned a link between antidepressant use during pregnancy and neurocognitive\/neurodevelopmental disorders in children, which is not supported by the most recent evidence<\/a>.<\/p>\n
One panelist disputed the effectiveness of antidepressants altogether \u2015 again contradicting the research<\/a>. Still another undermined the existence of depression in perinatal women (calling it a heightened emotional state<\/a>) and falsely claimed that doctors are pushing women to take antidepressants. <\/p>\n
In reality, of the estimated 14-23% of women who are diagnosed with maternal mental health disorders, only around 8% of them are taking an SSRI<\/a>. In fact, research<\/a> indicates that many women are reluctant to take antidepressants during pregnancy, and nearly 50%<\/a> of women taking an SSRI before pregnancy stop taking it during pregnancy.<\/p>\n
By the time I was diagnosed with OCD during graduate school in 2016, I had hit rock bottom. I couldn\u2019t sit through a therapy session without an elevated heart rate and sweaty palms, much less participate in the mindfulness exercises that my therapist provided for homework. Initially, I was reluctant to take medication. But with nothing to lose, I gave it a try, and my quality of life improved immeasurably. <\/p>\n
After a few years of taking 300mg of Zoloft and 10mg of Abilify daily, I switched to a newer medication, Viibryd<\/a>, also considered an SSRI, at the recommendation of my psychiatrist. When I got pregnant in 2022, I consulted with my psychiatrist and OB-GYN, who referred me to a maternal-fetal specialist for consultation. <\/p>\n
These three professionals agreed that the risk of continuing my antidepressant was minimal, and that it would be in mine and my baby\u2019s best interest to continue taking it if I felt comfortable doing so. I agreed, and we scheduled a fetal echocardiogram at 22 weeks to get a detailed look at the baby\u2019s heart due to the minor risk of cardiac defects associated with my medication.<\/p>\n
I gave birth to a healthy baby girl in October 2022 and experienced postpartum depression and anxiety following her traumatic entrance into the world. I decided to increase the dosage of my antidepressant with support from my psychiatrist. <\/p>\n
When I got pregnant again, unexpectedly, 10 months later, I didn\u2019t consider getting off my medication. And now that I\u2019m due with my third baby in three years, stopping my medication didn\u2019t even cross my mind.<\/p>\n
The panel omitted the fact that even before the MAHA movement, suspicion and distrust of medications (including vaccines) were on the rise \u2015 especially among women<\/a>. <\/p>\n
The link between medical distrust and the wellness industry has been well-documented<\/a>. In fact, Kennedy\u2019s MAHA movement owes much of its success to the \u201ccrunchy moms<\/a>\u201d promoting its agenda on social media. <\/p>\n
In other words, the FDA panel enhanced fear and skepticism amongst a population already vulnerable to misinformation<\/a>. If a black box warning label on antidepressants during pregnancy<\/a> is implemented, as is allegedly being considered, pregnant people could face even greater barriers to life-saving treatment.<\/p>\n
Ironically, several panelists stated that they wanted to better educate mothers, providing more information and full transparency about the risks of taking SSRIs during pregnancy. However, none of the studies referenced in the discussion were linked on the FDA\u2019s webpage. The ideas presented lacked nuance and framed one set of choices as right and the other as wrong \u2014 a hallmark of pseudoscience. <\/p>\n
Only one panelist, Dr. Kay Roussos-Ross, M.D., highlighted the potential benefits of antidepressants during pregnancy<\/a>. She shared that suicide is the No. 1 cause of maternal death during the perinatal period and referred to antidepressants as one of the \u201ctools\u201d available to combat this epidemic. <\/p>\n
Antidepressants may not suit everyone\u2019s needs, and they are not the only treatment for mental health (although they are often the most accessible). For many people with mental illness, they are considered the first line of defense and can even enhance the effectiveness of other treatment modalities.<\/p>\n
Taking my antidepressant makes me a better mom. My kids (including the one in my womb) reap the benefits of a mother who is not spiraling into a pit of anxiety and despair. <\/p>\n
Although it\u2019s not a magic bullet, my SSRI allows me to manage my pendulum of emotions and complete the many tasks and responsibilities that go along with being a working parent, military spouse, and mom to littles. <\/p>\n
The mild side effects and risks associated with taking my antidepressant pale in comparison to the risks of untreated maternal mental health disorders<\/a>, which include low birth weight, preterm birth, preeclampsia, difficulty bonding after birth and an overall increased risk of infant and maternal mortality.<\/p>\n
During the panel discussion, Roussos-Ross emphasized the importance of balancing the treatment of both mother and child, stating that one\u2019s health is not more important than the other\u2019s. When I watched the panel, it struck me how many of the \u201cexperts\u201d dismissed the mother\u2019s well-being, amplifying the pervasive cultural myth that mothers must deny their own needs in service to their offspring (which is promoted by trends like intensive mothering<\/a> and natural parenting). <\/p>\n