The recent drama surrounding  SSRI use in pregnancy and why I chose to stay on them. 

Last week the FDA held a panel to review the safety of SSRIs, also known as selective serotonin reuptake inhibitors, during pregnancy. What stood out to me was how heavily the discussion focused on potential risks of using medication and how little attention was given to the risks of untreated depression and anxiety.

As someone who has lived through both sides of that experience, I have a lot to say.

With my first pregnancy I was not on any medication. From early on I felt anxious every single day. I could not enjoy the experience. I struggled to be present. Instead of connecting with the moment I was constantly on edge, waiting for something to go wrong. After my baby was born the anxiety intensified. It was overwhelming. I made the decision not to breastfeed because for me the hormonal shifts of nursing made things worse. I felt like breastfeeding was prolonging the anxiety and I was just trying to make it through the day.

I loved my baby but I was struggling. And at the time I did not know what support I truly needed.

After I suffered the miscarriage in March 2021, I went on an ssri. I became pregnant again via IVF in September 2022. This time with twins, things were different. I was already on an SSRI to treat the postpartum anxiety that followed my first birth. I had no intention of stopping. I remembered how bad it had gotten the first time and I knew I could not risk that again. I was carrying two babies and raising a toddler. I needed to be mentally strong. I needed to stay afloat. I was not willing to gamble with my health or my children’s well-being.

I stayed on the SSRI during my pregnancy and I want to share what actually happened.

I carried my twins full term. They were both over seven pounds. I delivered vaginally. There was no NICU time. Most importantly, I felt like myself.

I did not experience postpartum depression. I did not even go through the baby blues. I was able to be present with my kids. I felt calm. I felt confident. I bonded with my babies right away. I enjoyed them. And because I felt good my children were thriving too.

That is the part of the conversation that was missing from the FDA panel. Most of the experts who spoke were not providers who work directly with pregnant people. They focused on theoretical risks. They did not speak to the real-world impact of untreated mental health struggles in pregnancy and postpartum. They did not talk about what it feels like to spiral into a dark place after birth or how hard it is to come out of that without support.

The American College of Obstetricians and Gynecologists released a strong response. They reminded everyone that SSRIs are generally safe in pregnancy and that for many people they are not optional, they are necessary.

And I agree.

Every person deserves a chance to feel well during and after pregnancy. Every parent deserves support. For me that support included therapy, lifestyle changes, and medication. My SSRI helped me show up for myself. 

When you are well, your children feel that. Your family feels that.

And that is what truly matters.