Ever since my latest bout with depression, I’ve been on a mission to find real, objective information about the risks and benefits of antidepressants during the preconception phase. This week I had the great fortune of attending a presentation by Beth Conover, MS, APRN, CGC, from the Nebraska Teratology Information Service. Although the presentation was designed for women’s health professionals, I slipped in as an incognito consumer and collected the uncensored, un-dumbed-down scoop.
The first piece of information that struck me is that just by being a human, every woman has a 3% chance of having a baby born with a congenital anomaly (aka something unusual or different at birth). Second, having untreated depression may up a woman’s risk for miscarriage, pregnancy-induced high blood pressure, preterm delivery, or low birth weight.
Some women require medication to treat their depression–that would be me. Medication during pregnancy carries risks. So, in my scenario, there are no zero-risk options. However, the good news is that there are low-risk options that have helped many women with depression and their babies get through and thrive through their preconception, pregnancy, and postpartum experience.
If you’re interested in the specific risks and benefits of a particular psychiatric medication during pregnancy and breast feeding, I encourage you to peruse the Organization of Teratology Information Specialists’ FAQ sheets in English and Spanish. Another tip is not to rely solely on the FDA codes that rank medications as category A, B, C, D, or X. They aren’t 100% based on scientific evidence. For example, birth control pills are in category X not because they are likely to cause serious harm to a developing fetus, but because they aren’t prescribed during pregnancy. If a woman is pregnant, why would she need birth control, right? It can also take a long time for a medication to move to the category that best reflects the current available scientific evidence.
I feel so privileged to be exposed to this information, and I wish that more straightforward resources were made available to women. Although the speaker really rocked her presentation, she said several times that what health care professionals need to know is different than what women need to know. Maybe it would be too much for some women, but I can handle the truth. Bring it on, please.