After the FDA’s July 2025 Expert Panel on SSRIs and Pregnancy, medical leaders, professional societies, and perinatal mental health organizations voiced widespread concern about the panel’s one-sided portrayal of antidepressant use in pregnancy. Experts across psychiatry, obstetrics, and maternal health emphasized that the event downplayed decades of evidence supporting the reproductive safety of SSRIs and failed to acknowledge that untreated maternal depression itself carries major risks for both mother and baby.

Over the last few weeks, several articles from perinatal psychiatry experts were published in the Journal of Clinical Psychiatry:

Why Getting Major Depression Right Matters—For Mothers, Babies, and All of Us – Jennifer Payne, MD

Prioritizing Mental Health to Optimize Perinatal, Fetal, and Neonatal Outcomes – Kay Roussos-Ross, MD; Tiffany A. Moore Simas, MD, MPH, MEd, MHCM; M. Camille Hoffman, MD, MSc; Emily S Miller, MD, MPH

PSI Response: FDA Panel Discussion Regarding SSRIs in Pregnancy – Postpartum Support International

Consensus Among Experts and Organizations

While the FDA expert panel raised concerns about the safety of SSRIs during pregnancy, there is strong consensus among medical experts regarding the importance of effectively treating mood and anxiety disorders in the perinatal period, supporting the vital and well-established role of SSRIs and other psychiatric medications as essential options for those who need them.

Across statements from national medical organizations, perinatal advocacy groups, and experts in maternal mental health, there is consistent agreement on several key points:

• Untreated or undertreated perinatal depression is dangerous.
  Perinatal psychiatric illness is associated with significant morbidity and mortality, whit recent studies indicating that suicide is a leading cause of pregnancy-related death in the United States. The consequences of untreated depression extend far beyond maternal suffering, and are linked to increased rates of preterm birth, low birth weight, impaired infant attachment, and poor neurodevelopmental outcomes for children. Both ACOG and the American Psychiatric Association underscore that effective treatment—including medication when indicated—is not optional, but essential to safeguarding maternal and infant health and reducing preventable deaths.
• SSRIs and other antidepressants are evidence-based, life-saving treatments for many pregnant and postpartum individuals.
  As ACOG President Steven J. Fleischman, MD stated, SSRIs “are life-changing and lifesaving” for those who need them. Scientific evidence from multiple large-scale studies and registries supports their reproductive safety when evaluated in context.
• Public misinformation or exaggerated risk claims can cause harm.
  Organizations including Postpartum Support International (PSI), the Maternal Mental Health Leadership Alliance (MMHLA), and the Policy Center for Maternal Mental Health warned that alarming or unsubstantiated statements about medication risks may discourage women from seeking care, thereby increasing the risk of untreated illness.
• Individualized, evidence-based decision-making is crucial.
  Professional societies (ACOG, APA, and SMFM) reaffirm that treatment choices during pregnancy should be made collaboratively between clinician and patient, using the best available evidence, and weighing risks associated with exposure to medication, as well as risks related to untreated psychiatric illness in the mother.

Core Themes in the Professional Responses

• Scientific validity: Experts such as Jennifer Payne, MD and Kay Roussos-Ross, MD highlighted the extensive epidemiological and clinical data drawn from hundreds of thousands of pregnancies demonstrate that, after controlling for potential confounding factors, SSRIs are not associated with major increases in congenital malformations or neurodevelopmental disorders.
• Clinical necessity: Treatment is essential. Those with milder forms of illness may respond to non-pharmacologic interventions. However, for those with moderate-to-severe or recurrent depression, medication is often required to maintain stability and prevent relapse, especially given the elevated vulnerability to mood and anxiety disorders during the perinatal period.
• Ethical communication: Several organizations urged the FDA to engage practicing clinicians and maternal mental health experts before convening future public panels, to ensure that guidance reflects prevailing scientific consensus and avoids stigmatizing treatment.

Shared Conclusions

Across obstetric, psychiatric, and maternal mental health communities, there is a clear consensus:

1. Both medication exposure and untreated mental illness carry risks, but the data show that for many women, treatment with SSRIs represents the safer and more effective option.
2. Public health messaging must reflect balanced, evidence-based information so that pregnant and postpartum individuals can make informed decisions in partnership with their healthcare providers.
3. Maternal mental health is integral to perinatal and infant wellbeing, and undermining confidence in evidence-based care jeopardizes progress made in reducing stigma and improving outcomes for families.

Resources for Patients and Providers

• American College of Obstetricians and Gynecologists
• Society for Maternal Fetal Medicine
• American Psychiatric Association
• MGH Center for Women’s Mental Health
• Postpartum Support International
• National Curriculum of Reproductive Psychiatry
• Policy Center for Maternal Mental Health
• Maternal Mental Health Leadership Alliance