Research on the subject has historically produced some scary findings. Selective serotonin reuptake inhibitors (SSRIs), the type of drug typically used to treat depression, have been associated with an increased risk of certain birth defects. But many of these older studies compared pregnant depressed women who are taking antidepressants to pregnant women with no history of depression, which is “like comparing apples and oranges,” says Pooja Lakshmin M.D., a perinatal psychiatrist and clinical assistant professor at the George Washington School of Medicine.
But newer studies are more nuanced, finally comparing the right control group—pregnant women with depression who take antidepressants vs. pregnant women dealing with untreated prenatal depression. In 2015, the Centers for Disease Control and Prevention did a critical review of past studies and added new research. They found that while some antidepressants can up the risk of birth defects, the overall risk is “very low.”
On top of that, recent research has found that not treating depression during pregnancy can also be harmful. “People are so worried about harming the baby with meds. But if you have prenatal depression and you don’t treat it you can still cause harm,” says Dr. Lakshmin. “Either decision comes with a risk.”
Untreated prenatal depression actually mirrors some of the same risks previously thought to be associated with taking meds for depression, such as preeclampsia, low birth weight and preterm delivery. Additionally, untreated prenatal depression can limit a woman’s ability to self-care, eat well and keep up with doctor’s visits—all things which studies show to be disruptive to maternal bonding and potentially harmful to the baby for years to come. “Women with prenatal depression are at risk for future depressive episodes and a lot of research shows that their parenting skills are negatively impacted,” says Darius Tandon, Ph.D., a psychologist and principal investigator for multiple Mothers and Babies projects, an evidence-based program, which aims to prevent postpartum depression. “There is evidence of negative outcomes not only in the first year of life but persisting into toddlers and school-going age or even into adolescence.”
The Stigma of Being a Medicated Mom
The good news is that prenatal depression is very much treatable. The bad news is that many women forego treatment because they can’t get past the stigma of seeking help.