Five Myths About Medications and Pregnancy

Did you know  that over 20% of women experience a perinatal mood or anxiety disorder (PMAD)?   These include much more than postpartum depression. PMADs can manifest as generalized anxiety, obsessive compulsive disorder, bipolar disorder, and, in very rare cases, psychosis.  PMADs can start during pregnancy or the first year after birth.  Many women feel powerless in this situation because they are afraid to take medication.  Read below to get the real information about medication during pregnancy:

1. Antidepressant medications can cause birth defects. This is False. We have learned a lot about medication safety over the last decade and can confidently say that SSRIs and SNRIs, the two most common classes of medication to treat depression or anxiety, do not cause birth defects. It was thought that Paxil could cause a heart defect, but further research disproved that. 
2. There is no risk for untreated depression or anxiety. This is also false. Moderate to severe anxiety or depression affects the developing baby and the whole family including older children and partners.  Children of mothers with untreated depression or anxiety are significantly more likely to have their own mood or anxiety disorder, learning disabilities, or behavioral issues.  This is not about blaming Mom, It is about motivating mom and the whole family to get help if needed. 
3. Moms who take medications are weak. There is nothing further from the truth. It takes a strong mind to admit that you need help and seek it. Psychotherapy and lifestyle changes can do a lot for mood or anxiety, but some people simply need more. Oftentimes, mood or anxiety disorders are about neurotransmitter deficiencies which respond well to medication. 
4. Moms who take medications don’t care about their baby. Again, nothing could be further  from the truth. Taking care of yourself ensures the best outcome for your baby. We know that there are no long-term risks in babies exposed to antidepressants (SSRI and SNRI) during pregnancy 
5. I cannot breastfeed if I take medication. Some medications like Zoloft are basically non-detectable in breast milk. Therefore, your baby would not be receiving any of it. Other medications do transmit to the breastmilk. However, for the most part have not been shown to be harmful. 

The good news is that over the last decade, we have learned a lot about medication safety during pregnancy.   We now compare the risk of untreated disease to the risk of exposing the baby to medications.  Some risks do exist such as an increased risk of miscarriage or preterm delivery.  However, they occur at the same rate in moms with moderate to severe PMADs as in those taking antidepressants.   There is also a risk of persistent pulmonary hypertension in the baby, a rare but serious condition.  Lastly some babies may experience withdrawal like symptoms.  It is important to have a discussion with both your obstetrician/midwife and a perinatal mental health specialist to find the best course of treatment for you.  

*This blog post originally appeared on my Psychology Today Beyond The Egg Timer Blog, posted 9/9/2020