Unii’s advice on any medication you want to take during pregnancy, including over-the-counter, everyday formulas you wouldn’t normally think twice about using, is to check with your doctor first. Antidepressants can interact poorly with a variety of other medications, including ibuprofen. If you are already taking antidepressants when you learn you're pregnant, contact your doctor for guidance as soon as possible.

According to the World Health Organisation, about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression. It is important to mention that these issues can develop in women with no previous or family history of mental health problems. Women should not feel so pressured to be joyful in their pregnant or matrescent state that they feel guilty or ashamed about asking for help. You can develop a mental illness at any stage of life. There is no pregnancy or new mum exemption.

Maternal mental health problems can impact entire families, as well as mum and baby, in devastating ways. Medication can be a safe and effective way to treat them when simple therapy, self-care, and lifestyle changes aren’t enough. However, it comes with a variety of potential risks, contraindications, and side effects, even when it’s a herbal or so-called natural remedy. Again, please do not take anything without seeking guidance from a healthcare professional who knows your medical history, as well as any underlying conditions or other medications you take that may affect outcomes.

When might I be prescribed antidepressants during pregnancy?

A decision to prescribe antidepressants while you are pregnant will likely come when your doctor decides that the potential benefits outweigh any risks. Untreated mental illness carries significant and wide-ranging risks for mum and baby, from preterm birth and low birth weight to self-harm and even suicide. A mother’s untreated mental illness can also impact a baby’s wellbeing after birth, increasing their cortisol levels and interfering with bonding.

Your decision to take antidepressants at any time in your life is extremely personal, and a mother should be supported by those around her when she makes it.

Which antidepressants will I be prescribed during my pregnancy?

Serotonin Reuptake Inhibitors (SSRIs) may be prescribed for perinatal depression and anxiety, as well as postpartum depression. There is more safety data for use in pregnancy of some antidepressants than others. SSRIs are considered to be the best studied. SSRIs are usually taken during pregnancy without any problems. Zoloft, also known as Sertraline, is the most commonly prescribed SSRI for pregnant and postpartum women, as there's lots of data supporting its safe use. Very little will enter your breastmilk. Other examples of SSRIs include Celexa, Lexapro, Prozac, and Paxil. SSRIs are not a homogenous class; each medication is different. Make sure you discuss any medication you choose to take (or switch to) in pregnancy thoroughly with your doctor.

Will I miscarry if I take SSRIs?

Some studies indicate that there is a slight increase in your risk of miscarriage if you take an SSRI. Others suggest there is little association. Still others suggest the risk is greater if you take one of another class of antidepressants, known as serotonin and norepinephrine reuptake inhibitors (SNRIs), so antidepressants and miscarriage can be quite a worrying thing to look into. Studying pregnant women’s use of antidepressants is hard because you can’t do randomised controlled trials (which would produce high-quality data) in order to see whether certain women are more likely to have adverse outcomes for a variety of logistical and ethical reasons. This leaves us with potentially problematic studies that look at association rather than causality.

Whichever antidepressant you are prescribed, you are entitled to a full discussion of any potential risks to you and your baby with your doctor before you take anything.

Will my baby be born with birth defects if I take SSRIs?

Some research associates antidepressants with heart defects in newborns, so there may be some risk of this. Your doctor may recommend you avoid taking antidepressants until after the first trimester or altogether as a result. Your doctor will also consider the risk to you and your unborn child if your mental health issue is left untreated. What may be encouraging for mums with depression to know is that if the association were common, we would know by now. Any associations that exist are relatively small.

Will my baby be premature if I take SSRIs?

No, and in fact premature birth may be more likely if a mother’s mental health problem is left untreated, be that through medication or some other method. A 2024 study published in npj Women’s Health showed that taking SSRIs in pregnancy does not increase your risk of preterm birth.

Will my baby develop autism, ADHD, or behavioural problems later in life if I take SSRIs?

No, there is no evidence that your baby will develop autism, ADHD, or behavioural problems after birth if you take SSRIs when you are pregnant.

Will my baby experience withdrawal from SSRIs after birth?

This is possible. Mothers on antidepressants may be told they should have their baby in a hospital rather than a birth centre or at home, so your baby’s withdrawal can be monitored. Babies whose mothers are taking antidepressants will be used to having the medication in their systems by the time they are born. When this supply is cut, babies experience a period of transition in which they require closer monitoring. This usually happens in the first few days of life, and you will be told to stay in the hospital until your healthcare team is sure the baby is stable. They may also warn you that withdrawal symptoms can be similar to symptoms of baby meningitis. They should explain anything you should look out for and give you numbers to call in case you are worried or believe there is an emergency.

For more information on managing pregnancy symptoms, watch Dr. Shree Datta's Pregnancy week-by-week video course.

For more on navigating the postpartum period, watch Unii's Giving Birth Journey video course with Dr. Keith Duncan.

Can I take antidepressants in pregnancy?

Unii looks at this extremely important question from mother's with maternal health problems.