For many people who have been using antidepressants to deal with mental health conditions such as depression or anxiety, pregnancy can be a scary situation. Especially since the impact of medications on pregnancy is often undermined and not talked about much.
The patient’s perspective and their loved one’s perspective regarding the use of psychiatric medications during pregnancy often collide making the misconceptions believed by people crucial yet challenging to deal with.
Based on Deutch experience with patients, the use of medications has become a concerning topic for pregnant women. During her medical visits with patients, she has frequently been asked questions regarding how psychiatric medications affect the baby. The possible withdrawal symptoms, risks the medications pose and their impact on both mothers and baby’s life.
Deutch thereby highlights the importance of treating mental conditions during pregnancy which can be depicted by research. A cross-cultural literature review showed that the presence of disturbance in maternal mental health during pregnancy can result in less optimal birth outcomes (Satyanarayana et al., 2011).
An obstetrician-gynecologist also said that the decision to deal with depression while being pregnant is not as simple putting one well-being over another. Rather than allowing the shame in talking about mental health and its pressure on expectant parents, we should talk about how much nuanced this conversation has become.
Medications Vs Untreated Mental Conditions
According to Deutch, the decision to stay on or off medication during pregnancy is more like analyzing the risk vs risk. To elaborate, it is decision being made against what is the risk of taking medications for mom and baby versus what is risk of untreated maternal mental illness on mom and baby.
When using drugs, parents must consider important issues such low birth weight, preterm birth, and developmental and perinatal abnormalities.
The most widely used medication for treating depression is selective serotonin reuptake inhibitors (SSRIs), and the data surrounding its impact during pregnancy has been reassuringly safe. According to CNN report, the risk of birth deficits upon SSRI intake during pregnancy has been lower than baseline.
In addition, antidepressant usage during pregnancy was not found to be associated with mental health conditions such as autism, attention-deficit hyperactivity disorder (ADHD), behavioral disorders, developmental speech, language, learning, and coordination disorders or intellectual disabilities.
Sophocles later added that serotonin and norepinephrine reuptake inhibitors (SNRIs) and other medications in the same category might have a lower risk compared to other medications. Consequently, these drugs can be choices for doctors, but only with their consent. Because even if the risk is modest, nothing, not even paracetamol, can ensure poor birth outcomes.
We shouldn’t treat pregnant women with medicines carelessly, according to Vaughn. Instead, we should think about the true danger of ignoring sadness because it will affect both the mother and the foetus as it develops.
Risks of Untreated Depression During Pregnancy
Depression during pregnancy, according to Vaughn, might prevent a mother from attending prenatal checkups on time, taking prenatal vitamins, or making sure she gets enough nutrition to support her pregnancy.
At the same time, it is essential to remember that taking care of the mother is also taking care of the baby. As reams of data support the idea that when the mother is functioning well, the whole household may not function well either based on Vaughn’s opinion.
According to Vaughn, prenatal melancholy can prevent mothers from attending prenatal checkups on time, taking prenatal vitamins, or making sure they are eating enough to support their pregnancy.
On the other hand, the infant may be at risk from the untreated depression of mother. As Deutch said, what infants really need are responsive parents, which is not easy to achieve with depression. Depression can cause a lack of engagement and connection that the baby needs.
This thereby enforces the Deutch statement, “A healthy mom makes a healthy baby”
How to decide?
Many patients often fail to recognize that they may be suffering from mental conditions during their pregnancy or postpartum period. They may consider their worries about their child’s stages of development, lack of sleep, or missing showers with the baby as a normal part of the process.
It is common to worry over your child, but it is troublesome when the worry becomes extensive. When the worries impede your life, making you feel hopeless, helpless, or worthless, it may be the time to talk to your doctor according to Vaughn. According to her, the amount of time spent worrying and the extent it impacts our functioning should be the focus.
Regular conversations with your doctor regarding your feelings and proactive talking among medical professionals may help reduce these issues and promote healthier pregnancies. Even if you aren’t pregnant but considering getting antidepressants, talking abouts its impact and implications for pregnancy can act as a good protective measure.
Also, it is necessary to remember medications are not always the solution for every individual suffering from mental conditions. Some people might benefit more from therapies such as psychotherapy and cognitive behavioral therapy rather than antidepressants for depression or anxiety during pregnancy.
The primary advice given by Vaughn is to talk to your doctor and give yourself permission to select the choices best for both you and your baby. In simpler terms, follow your doctor’s advice but also listen to your instincts.