- A recent article in the New York Times about the use of antidepressants by pregnant women resulted in a fury of protest from clinicians. "The article is likely to foster unnecessary fear among women who struggle with mood disorders who are pregnant or plan to become pregnant. The implication that women idly choose to start or to remain on antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs), or any other medication during pregnancy, is insulting and demeaning," saidAnn D. S. Smith, CNM, and President of Postpartum Support International, the leading organization dedicated to helping women suffering from perinatal mood disorders.
Women who, under a healthcare provider's care, choose to remain on medication do so to counter moderate to severe depression or anxiety symptoms that would otherwise render them functionally impaired. "To equate treatment with an antidepressant to quell the suffering from a perinatal mood and anxiety disorder to the abuse of illicit drugs is an egregious misrepresentation that vilifies women who want nothing more than to feel the excitement of pregnancy and the joy of new motherhood. Medications aren't perfect. Some women may be able to get by with complementary treatments like acupuncture, massage, yoga, and talk therapy alone, but most women who are seriously ill need some form of pharmacology to improve," said Carly Snyder, MD, Reproductive Psychiatrist, PSI Research Chair.
All medical consultations on every level involve the assessment of risk vs. benefit. Mothers, families, and psychiatric prescribers must be prepared to have these conversations free from the bias of outside friends and family, scare media, or old wives' tales. "To date, after many studies that have evaluated the safety/risk of antidepressant use in pregnancy, including thousands of women, none of these drugs have been found to substantially increase the risk of any adverse outcomes. Women and their health care providers should not be unduly concerned if a woman requires an antidepressant, as this is no different than being treated for other serious medical conditions during pregnancy that require medications," said Adrienne Einarson, RN, Reproductive Psychiatry Group Founder.
If a woman had diabetes and required insulin to remain healthy and to function, would anyone question her use of insulin in pregnancy? Of course not. Psychotropics are just like insulin in that they treat a medical condition that is otherwise functionally debilitating, and potentially deadly. We as a society must stop demonizing women suffering during and after pregnancy, and instead support, nurture, and empathize as women struggle, and hopefully receive the necessary treatment and then get well.
Postpartum Support International has volunteers in all U.S. states and 40 countries. A detailed response to the NYT article may be found on their website, www.postpartum.net.