Pregnancy is a time of great emotional and physical changes. For women with a history of mental health challenges, it can also be a time of difficult decisions. In order to determine whether to continue taking antidepressants while pregnant, you and your doctor must seriously consider the state of your health. Antidepressants can increase the risk of complications in pregnancy. However, sometimes the level of risk is acceptable when weighed against the benefits.
Antidepressants and Birth Defects
Healthcare professionals are in agreement that if you are low-symptom or have been asymptomatic for more than six months, the most ideal course of action would be to avoid antidepressants.[1] According to epidemiological studies, the risk of taking antidepressants during pregnancy can include:
- premature birth
- decreased body weight of the child
- intrauterine growth retardation
- neonatal adaptive syndrome
- persistent pulmonary hypertension[2]
If you take antidepressants in the third trimester, your baby can go through withdrawal symptoms after birth that include:
- jitters
- irritable behavior
- poor feeding
- respiratory distress
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants, and they are associated with minimal risks.[3] Different antidepressants will affect your baby differently. Some tricyclics are associated with heart defects in infants.[4] That’s why it’s important to talk to your doctor and proceed with caution. However, even though antidepressants can pose risks, untreated depression can also pose risk to the baby.
The Risks of Untreated Depression
Even though antidepressants can pose risks, untreated depression can also adversely affect maternal health and increase the risk of preeclampsia and eclampsia, as well as of subsequent postnatal depression, which can lead to disruption of the mother-child relationship. Depression is a serious mental health condition that affects a person’s mood, energy levels, and overall ability to function. For some women, pregnancy can exacerbate symptoms of depression, making it even more important to manage mental health effectively. Untreated depression during pregnancy is associated with several negative outcomes, including:
- Premature birth
- Low birth weight
- Developmental delays
- Higher likelihood of postpartum depression
- Difficulty bonding with the baby after birth
In severe cases, untreated depression can also increase the risk of self-harm or suicidal thoughts, making it critical for women to receive appropriate treatment.
The cost-benefit analysis of taking antidepressants while pregnant
You and your doctor must weigh the treatment risks against the treatment benefits. Remember that maternal mental health plays a significant role in the well-being of both mother and child. Ultimately, the decision to continue or discontinue antidepressants during pregnancy should be made in close consultation with a healthcare provider. Every pregnancy is unique, and factors like the severity of the mother’s depression, her past mental health history, and the specific medication being used will all influence the decision. This decision can be very challenging, which is why our pregnancy resource center commits to providing medically accurate information as you go about making the best choices for you and your child.