For too long, mental health in pregnancy has been an afterthought — if it’s considered at all. And last week, when the FDA convened an expert panel to evaluate the use of SSRIs (selective serotonin reuptake inhibitors) during pregnancy, that reality was put under a microscope.
On a panel of 10 experts, only one highlighted the very real and urgent need for access to SSRIs as part of a broader toolkit to treat perinatal mood disorders. The rest focused largely on fear, speculation, and stigma, with little acknowledgment of what can happen when these conditions go untreated.
Let’s be clear: depression and anxiety during pregnancy are common. Up to 1 in 5 pregnant people experience perinatal mood and anxiety disorders (PMADs). And when left untreated, these conditions can have serious, even life-threatening consequences, including preterm birth, low birth weight, preeclampsia, impaired bonding, and suicide. Mental health conditions are now the leading cause of pregnancy-related death in the U.S.
So why are we still debating whether people should have access to the medications that help keep them well?
SSRIs save lives, and the science supports that
The idea that SSRIs are inherently dangerous in pregnancy is not only outdated — it’s inaccurate. According to the American College of Obstetricians and Gynecologists (ACOG), “robust evidence has shown that SSRIs are safe in pregnancy and that most do not increase the risk of birth defects.”
In a statement released following the FDA panel, ACOG President Dr. Steven J. Fleischman emphasized just how essential these medications can be:
“Not every pregnant person needs SSRIs, but for those who do, they are life-changing and lifesaving. Mental health conditions are already the most frequent cause of pregnancy-related death. Unfortunately, the many outlandish and unfounded claims made by the panelists regarding SSRIs will only serve to incite fear and cause patients to come to false conclusions that could prevent them from getting the treatment they need.”
That’s the heart of the issue. Fear, misinformation, and stigma are standing in the way of access to real, effective care. And patients are the ones who suffer.
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No one is saying SSRIs are the right choice for everyone. But they are a critical option for some, and every patient deserves the opportunity to make that decision in partnership with their provider, based on their unique needs and values.
As someone who experienced postpartum anxiety and OCD after my first pregnancy, and who chose to remain on an SSRI during my most recent pregnancy, I know firsthand how hard and deeply personal that decision can be. For me, staying on medication wasn’t about choosing myself over my baby; it was about protecting us both.
ACOG also responded to a particularly harmful narrative that was echoed throughout the panel: that patients are not adequately informed about the risks of SSRIs during pregnancy. As the organization stated,
“Patients who choose to continue taking SSRIs during pregnancy with the support of their ob-gyns do so following counseling on the risks and benefits that includes discussion of the data and consideration of their own needs, values and priorities.”
In other words, patients aren’t being misled. They’re being supported with evidence, empathy, and expert guidance.
What we really need is more research, not more fear
One thing the panel did get right: we need more data. ACOG acknowledged that “randomized trials to assess the safety of SSRIs have not been conducted and should be prioritized.” The organization has long called for the inclusion of pregnant and postpartum people in clinical research to better understand how medications affect this population.
Progress was actually underway. The FDA and the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development had begun developing working groups focused on treatment options for pregnant, postpartum, and lactating people, including one specifically for SSRIs.
But according to ACOG, “that work has now been stalled due to the administration’s recent significant cuts to the NIH.” So just when we need more clarity, we’re losing the infrastructure that could provide it.
And once again, people navigating pregnancy are left with limited information, loud opinions, and far too much fear.
Here’s the good news: We can do better
Despite the discouraging tone of last week’s panel, there is hope, and there is momentum. ACOG’s response was clear, compassionate, and evidence-based. They aren’t just defending access to medication; they’re defending the right of every pregnant person to make informed, individualized decisions about their care.
And that’s exactly what we need more of.
Perinatal mood and anxiety disorders are real. They are common. And they are treatable. But only if we stop politicizing pregnancy and start treating mental health with the same urgency, funding, and respect as physical health.
Access to SSRIs (and other tools for managing mental health in pregnancy) isn’t a luxury. It’s healthcare. It’s science. It’s self-care. And it’s time we started treating it that way.
Kristyn Hodgdon is a passionate women's health advocate and the Co-Founder and Chief Creative Officer of Rescripted, where she helps break down complicated medical info into content that's easy to understand — and actually helpful. As an IVF mom who’s experienced pregnancy loss and lives with PCOS, Kristyn blends her professional know-how with real-life experience to support others navigating similar journeys. Her work has been featured on Good Morning America, ScaryMommy, and more, and she’s the host of the podcast From First Period To Last Period. A Fordham University grad, Kristyn also volunteers with the Fly Again Foundation, which supports breast cancer patients. You can find her on Instagram or connect with her on Linkedin.