Pregnancy and postpartum are often described as seasons of bliss, with the assumption that instinct and love will naturally take over as a guide. Reality is much more layered; alongside moments of excitement and joy, many women may face intense sadness, anxiety, or distressing intrusive thoughts. And yet, despite how common these experiences are, seeking care can often come with shame, fear, and uncertainty.
When depression, anxiety, or overwhelming stress arise, mothers may feel isolated or begin to wonder if something is wrong with them. These feelings are not signs of weakness; they reflect how much work needs to be done to normalize and support maternal mental health.
Recently, an FDA advisory panel reviewed the use of SSRIs (selective serotonin reuptake inhibitors)–one of the most widely used and commonly prescribed medications for treating depression and anxiety–during pregnancy. Headlines largely emphasized the possible risks of taking medication, while overlooking the significant risks of untreated maternal mental health struggles.
Careful reviews of the data consistently show that SSRIs are among the most extensively studied medications in pregnancy. While no treatment is ever entirely risk-free, these potentially life-saving medications are widely considered safe for both mother and baby. Untreated maternal mental illness, by contrast, carries serious risks, including preterm birth, difficulties bonding or feeding, and maternal suicide, which, alarmingly, is a leading cause of death in women in the first year postpartum.
The gap between the reassuring strength of the research and the confusion women and clinicians alike feel when trying to interpret it is striking. Mothers are often told to avoid all medications if possible, while also being urged not to ignore depression or anxiety. Clinicians may feel caught between alarming headlines and reassuring data, leaving patients with the impression that no one really knows what is safe. For women navigating one of the most vulnerable seasons of their lives, this conflicting messaging can be paralyzing, and many end up silently suffering rather than risk doing anything they fear could harm their baby.
Naming the potential hardships of the transition into motherhood should not be pathologized. Recognizing the struggles mothers face allows us to also recognize their strength. In the case of mood and anxiety symptoms, seeking help is an act of resilience. Honest conversation about the challenges of motherhood dismantles shame and makes space for others to step forward.
As clinicians, it is our responsibility to meet our patients with empathy, offer clarity where the science feels confusing, and guide them through complex decisions with compassion. Whether through therapy, peer support, or medication when indicated, treatment should be considered a necessity not a luxury.
At Foresight, our Maternal Mental Health Program brings together psychiatric providers and therapists with specialized training and a deep personal commitment to this work. We are continually learning, collaborating, and striving to stay informed so we can support mothers with both evidence and empathy. Our goal is simple: to ensure you feel seen, understood, and fully supported. By creating a space for vulnerability and walking alongside women through uncertainty, we hope no mother ever feels she is alone.
References
- Centers for Disease Control and Prevention. Maternal Mental Health. CDC website. Updated May 14, 2024.
- Suarez EA, et al. Prevalence of antidepressant use during pregnancy in the U.S.: Estimates from health records. JAMA Internal Medicine, 2022.
- National Institutes of Health, National Library of Medicine. Selective Serotonin Reuptake Inhibitors (SSRIs) and Pregnancy: An Overview. Updated February 2024.
- American College of Obstetricians and Gynecologists (ACOG). Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum: Clinical Practice Guideline No. 5. Obstet Gynecol. 2023;141(6):1262-1288.
- Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-281.
