The Complex Conversation Around Treating Mental Health During Pregnancy: Risks vs Benefits

Dubai, United Arab Emirates (CNN) — Pregnancy can seem like a terrifying choice between the mental health and well-being of a future baby for people dealing with anxiety or depression with antidepressants.

“Some health care providers and patients alike believe that psychotherapy is not compatible with pregnancy,” said Dr. Allison Deutch, director of reproductive psychological counseling at NYU Langone Medical Center.

“Fighting this misconception, from both the patient’s and the provider’s perspective, is one of the most difficult aspects of working in this field,” added Deutch, an assistant professor of psychiatry at NYU Grossman College of Medicine as well.

During her work as a gynecologist for the past 28 years, Dr. Maria Sophocles said that what she has often seen is the willingness of her patients to put others before themselves, even if it hurts them.

Sophocles, medical director of Women’s Healthcare of Princeton in New Jersey, explained that deciding how to treat a woman’s depression during pregnancy is not as simple as prioritizing one person over another.

With the stigma attached to mental health, and the stresses that expectant mothers face, it is important to address the complexity of the conversation surrounding the use of medication to treat anxiety and depression during pregnancy.

Risks vs greater risks

In many medical conditions, people make decisions by weighing risks and benefits.

But when deciding whether to continue taking antidepressants during pregnancy, Deutch notes, it’s like doing a risk analysis against the bigger risks.

“We balance the risks of exposing mother and child to medication against the risks of untreated psychiatric illness affecting both mother and child,” Deutch explained.

When it comes to medication, Dr. Robiana Vaughn, director of counseling, communication and emergency psychiatry at New York’s Jacques de Wheeler Hospital, said concerns include risks of low birth weight, premature birth, growth problems and birth defects.

Sophocles mentioned that the risk of complications from antidepressants during pregnancy is low, but nothing is completely without danger when it comes to adverse birth outcomes.

On the other hand, untreated depression during pregnancy is associated with a higher risk of low birth weight and premature birth.

Taking care of a mother is like taking care of a child

The difficulty of having a healthy pregnancy makes sense when parents are struggling.

“If you’re depressed and you’re pregnant, it’s very difficult to get to your appointment with the doctor,” Vonn said. “It’s really hard to take prenatal vitamins and make sure you’re getting enough nutrition to support your pregnancy.”

Risks lurk after the baby is born, too.

Talk to the doctors

For women who experience depression or anxiety for the first time during pregnancy or in the postpartum period, it may be difficult to recognize the symptoms.

But when anxiety starts to get in the way of their lives, or they feel hopeless or helpless, it may mean it’s time to talk to a doctor, Vaughn says.

Sophocles recommends talking to your doctor regularly, adding that simply getting to the door and starting a conversation can help pave the way for a healthier pregnancy.