August 7, 2007

Pregnant and on meds

I just love this conversation that's evolved from my post (a couple of posts back) on taking anti-depressants when breastfeeding! I set out simply to give my personal opinion on the risks involved and now feel way more enlightened on this "hot button" topic. In the midst of the mixed messages we get from drug test results and the medical community, we're left to wade our way through the murkiness of this issue while feeling guilty about whichever decision we choose.

I especially love psychologist and nationally-renowned PPD expert Ann Dunnewold's comment that "we need more honesty among women that this decision is hard" and that "women need to stop judging each other. Society as a whole is hard enough on us, setting up perfectionist, unreachable standards for mothers. We need to keep in mind the absolute truth, for the majority of women: that we are all doing the best we can do."

Several women have commented on my previous posts on this topic, openly sharing their experiences. One is now in the sixth month of her pregnancy with her second child. Not only did she suffer from PPD with her first baby, she has also dealt with severe depression since she was 13 years old. She is currently taking Zoloft and plans to stay on the anti-depressant during her postpartum while breastfeeding. She brought up an extremely valid concern that I hadn't touched on .... although we've been talking about the risks that anti-depressants pose to an infant, what about the risks involved when a mom's depression is left untreated? Studies show that the occurrence of untreated postpartum depressive episodes in a mother is linked to poorer cognitive test scores in their children. And way more tragic -- aside from the potential cognitive and development delays and possible psychological damage -- there is also the risk of a child losing a mother to suicide.

I want to thank this very strong and empowered woman for sharing her story -- openly letting us in on her decision that she's made to be on Zoloft while pregnant -- and bringing up this very important point that weighs heavily in this excruciating decision that so many of us have to face head on. I wish her all the best with the rest of her pregnancy and hope she keeps in touch so we can all celebrate with her when she experiences a joyful, calm PPD-free postpartum!


passing as myself said...

Thanks for the compliments, Kristin. Ms. Dunnewold is right, these are very difficult decisions. It touches me deeply to be called "strong and empowered" at a time when I often feel just overwhelmed.

Btw, I'm trying to watch my pregnancy weight gain because I started this one overweight (left over from the first one, I'm afraid). And I would put money on a bet that you were gorgeous even in that final trimester!

Shoshana Bennett said...

As Anne Dunnewold expressed, the judgment needs to go. There is no one “right” way. Each mother is trying to make the best decision for the wellbeing of her baby, and whatever choice feels right for her needs to be respected and supported. In order to make the best choice she can for the welfare of her family, it’s also important for the mom to have solid information on the pros and cons when she make this important decision. Here are some facts which many are not aware of. Most medical professionals who have dedicated their careers to studying the safety of antidepressants in pregnancy agree that they have been focusing too heavily on one side of the issue for years. Now, instead of solely focusing on the possible unknown risk to the baby when the mom takes medicine, they are leaning much more on the KNOWN risks to the baby if the mom is NOT treated. Until a few years ago, most of the focus with respect to taking medications while pregnant was on the possibility of harming the baby. Today, since there is much more data gathered on the dangers of depression and anxiety to the developing baby, the focus has shifted to the possible harm from NOT taking medication if the pregnant woman needs it to feel like herself. It’s quite clear from the research in the last few years that depression and anxiety in pregnancy can chemically hurt growing babies. For instance, depression in pregnancy can cause low birth weight and preterm delivery, and anxiety may cause harm by constricting the placental blood vessels and raising cortisol. One thing is for sure that everyone agrees upon. If a woman is experiencing depression or anxiety during pregnancy, she and her whole family (big or little, born or not yet born) needs her to receive treatment. Treatment, of course, does not necessarily involve medication, it’s simply the topic of this discussion. On that note, we are learning quite a bit about effective non-pharmaceutical treatments for depression in pregnancy with no side effects except good ones!

Shoshana S. Bennett, Ph.D. Author, Postpartum Depression For Dummies


First of all, thanks for your honest and informative website.

As a psychiatrist, I can provide medically sound information; however, the decision to take medications while pregnant or breastfeeding can be enormously difficult. The women I care for feel guilty first of all because they are depressed at a time when they are expected to be unambivalently happy. Having to take a medication can make them feel even worse.

Having a website where women are comfortable to share their own experiences is enormously powerful. Your website sends the message that being depressed does not mean that a woman is unprepared, unwilling, or unable to be a loving mother. This website also makes the point that taking care of herself is one of the best things a mother can do for her child.

Again, thanks for your efforts!

Ruta Nonacs MD, author of A Deeper Shade of Blue: A Woman's Complete Guide to Recognizing and Treating Depression During Her Childbearing Years.

More information at

Kristin said...

Dr. Nonacs,
Thanks so much for your wonderful comment! I haven't read your book but will go pick it up. Your web site is fantastic -- I'll definitely link to it to spread the word about the great work you do.
Warm regards,