Yesterday, July 21, 2025, the FDA convened a panel to evaluate the safety and use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy. What should have been a thoughtful, science-led discussion about evidence and outcomes became, instead, a disturbing display of bias, misinformation, and fearmongering.
As a perinatal psychiatrist who has walked alongside countless pregnant and postpartum patients navigating the complex terrain of mental health, I cannot stay silent. The rhetoric used by this panel was not only scientifically unfounded—it was harmful.
Only one of the ten panelists (a triple Board-Certified physician in OBGYN, Psychiatry and Addiction Psychiatry, Dr. Roussos-Ross, MD) acknowledged the extensive body of evidence showing that SSRIs can be safe and effective during pregnancy. The rest? They leaned into stigma, implying that patients are being misled or coerced into taking medications they don’t need. This kind of language ignores the reality faced by patients every day.
Untreated depression and anxiety in pregnancy are not benign. They are associated with:
As ACOG’s President, Dr. Steven Fleischman, MD, said in a recent statement: “Mental health conditions are already the most frequent cause of pregnancy-related death. Unfortunately, the many outlandish and unfounded claims made by the panelists regarding SSRIs will only serve to incite fear and cause patients to come to false conclusions that could prevent them from getting the treatment they need.”
The assertion that patients are being “deceived” or “not counseled” about risks is not only offensive—it’s patently false. In my practice and among my colleagues across the country, we dedicate time to shared decision-making. We sit with our patients, explain the data (and its limitations), explore their fears, and empower them to make informed choices that align with their values. It is one of my favorite parts of this field because I truly value my patient's autonomy to make decisions that are right for them. That is what ethical, compassionate reproductive mental health care looks like.
To suggest otherwise is to erode trust in the doctor-patient relationship at a time when patients need it most.
While no medication is completely risk-free, the existing evidence shows that SSRIs:
And yet, the panel failed to meaningfully engage with this body of research. Instead, they relied on anecdotes, outdated data, and a narrative of blame.
It’s true that we need more robust studies—randomized trials that include pregnant people, longitudinal data on long-term outcomes. But until then, we cannot let perfection become the enemy of progress. We must work with the best available evidence and prioritize access to care, not restrict it based on ideology.
The reality is: Not every pregnant person who is experiencing depression or anxiety needs an SSRI. But for those who do, these medications can be life-changing—and even lifesaving.
We do not ask patients with diabetes or epilepsy to go without their medications during pregnancy. We find ways to support them, mitigate risks, and preserve their health. Mental health deserves the same treatment.
To my fellow clinicians: Keep showing up. Keep having the hard, honest conversations. Keep advocating for your patients.
To patients who are struggling: You are not alone. Your mental health matters. You deserve evidence-based care and nonjudgmental support as you navigate this chapter.
To policymakers and public health leaders: Let’s move away from rhetoric and toward meaningful investment in maternal mental health, research, and systems of care.
Pregnancy is not a time to deny care—it’s a time to expand it.
Is ingesting your placenta evidence-based for postpartum mental illness? Learn more in this article.
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