SSRIs During Pregnancy: What You Need to Know About Safety, Risks, and Alternatives

When you’re pregnant and struggling with depression or anxiety, SSRIs, a class of antidepressants that increase serotonin levels in the brain to improve mood. Also known as selective serotonin reuptake inhibitors, they’re among the most commonly prescribed medications for mental health during pregnancy. But the question no one wants to ask—yet everyone wonders—is: are they safe for your baby?

It’s not a simple yes or no. Studies show that SSRIs, including sertraline, fluoxetine, and citalopram, cross the placenta and reach the fetus. Some research links them to a slightly higher chance of preterm birth, low birth weight, or temporary newborn symptoms like jitteriness or breathing trouble—often called neonatal adaptation syndrome, a set of mild, short-term symptoms in newborns exposed to SSRIs late in pregnancy. But the bigger picture? Untreated depression carries its own risks: poor prenatal care, unhealthy eating, even preterm labor. For many women, the benefit of staying stable outweighs the small, manageable risks.

Not all SSRIs are the same. Sertraline is often the first choice because it has the most data showing lower risk to the fetus. Fluoxetine stays in the body longer, which might mean longer exposure for the baby. And while some women switch medications before getting pregnant, others find stopping cold turkey triggers worse symptoms than the pregnancy itself. That’s why decisions like these aren’t made in a vacuum—they need to involve your OB, your mental health provider, and sometimes a maternal-fetal medicine specialist.

There are also non-drug options that help. Cognitive behavioral therapy (CBT) has strong evidence for treating depression during pregnancy. Exercise, sunlight, and sleep routines can make a real difference. But if your symptoms are severe—like having thoughts of harming yourself or not being able to get out of bed—therapy alone might not be enough. That’s where SSRIs come in. They’re not a quick fix, but for many, they’re the difference between surviving pregnancy and drowning in it.

What you’ll find in the posts below isn’t just a list of risks. It’s real talk about what happens when you’re on these meds, how to spot the difference between normal side effects and something serious, and how to talk to your doctor without feeling judged. You’ll see how other women navigated this, what their doctors told them, and how they weighed the trade-offs. This isn’t about fear. It’s about making informed choices—with clarity, not confusion.