Medication During Pregnancy & Postpartum: What You Need to Know

Pregnancy and the postpartum period can be an emotional and overwhelming time. For many, the decision about whether or not to use medication can feel daunting. In this piece, we’ll break down what you need to know to make an informed decision that’s right for you.

1. Understanding the Need for Medication

Mental health conditions like anxiety, depression, and postpartum depression can significantly affect your well-being during pregnancy and after childbirth. It’s important to acknowledge that taking care of your mental health is just as important as your physical health during this time.

For some, therapy and lifestyle changes are enough, but others may need medication to help manage their symptoms. There is no shame in choosing medication—it can be a vital tool for maintaining balance.

2. Safety of Medication During Pregnancy and Postpartum

One of the most common concerns is the safety of taking medication during pregnancy or while breastfeeding. The good news is that research has shown that many medications are safe during these periods when prescribed and monitored properly with a trusting relationship with your provider

• During Pregnancy: Some medications, like certain antidepressants or anti-anxiety drugs, are generally considered safe when used under medical guidance. However, some medications may carry risks, so it’s important to have an open conversation with your doctor to weigh the pros and cons.

• During Postpartum: Many women who are breastfeeding may be concerned about how medications will affect their baby. The good news is that many antidepressants and other medications are considered safe for breastfeeding mothers. Your provider can guide you toward medications that are low-risk for both you and your baby. We can provide updated, evidence based data to help in your decision making.

3. Types of Medications Commonly Used

Here’s a quick overview of medications that are often used to treat mental health conditions during pregnancy and postpartum:

• Antidepressants (SSRIs & SNRIs): These are commonly prescribed for depression and anxiety and are generally considered safe for use during pregnancy and breastfeeding.

• Mood Stabilizers: For those with bipolar disorder, mood stabilizers may be necessary, and there are options available that are considered safe during pregnancy and breastfeeding. These are also used at times for sleep, depression and anxiety as well.

• Zurzuvae (brexanolone): A medication specifically approved to treat postpartum depression (PPD) in adults. It is a neuroactive steroid that works by enhancing the GABA (gamma-aminobutyric acid) system in the brain, which helps to reduce depressive symptoms.

• Other Options: Therapy, lifestyle changes, exercise, supplements and nutritional support can also complement or sometimes serve as additions or alternatives to medication.

4. The Benefits of Medication

While it can be tough to make the decision, here are some of the key benefits of taking medication during pregnancy or postpartum:

• Reduced symptoms: Medication can help reduce symptoms of depression, anxiety, and other mood disorders, making it easier to engage with life and care for your baby.

• Better sleep: Medication can help with sleep disturbances, which are common during pregnancy and after childbirth.

• Improved functioning: When your mental health improves, you can better manage daily tasks, maintain relationships, and care for your baby.

• Less stress: For many, knowing they are addressing their mental health concerns can reduce stress and help them feel more in control.

5. How Medication Can Support Therapy

When it comes to managing mental health during pregnancy and the postpartum period, medication and therapy often work best together versus medication alone. While therapy provides the tools and strategies to manage stress, anxiety, depression, and other mental health challenges, medication can help create the stability needed to engage fully in therapy and make lasting changes.

1. Stabilizing Symptoms: Medication, particularly antidepressants or anti-anxiety medications, can help stabilize your mood, reduce overwhelming feelings of anxiety or sadness, and make it easier to think clearly. When your symptoms are under control, you are more likely to benefit from therapy, because you can focus on the therapeutic work without being overwhelmed by your emotions or mental state.

2. Enhancing Engagement in Therapy: Mental health conditions like depression or anxiety can make it difficult to engage in daily life, let alone attend and actively participate in therapy sessions. Medication can help reduce the severity of these conditions, allowing you to feel more motivated and present during therapy, leading to better progress. Medication can create the mental clarity needed to do this deep work effectively. With symptoms under control, you may find that you're able to make more progress in therapy, resulting in better long-term outcomes.

3. Reducing Relapse or Setbacks: For many individuals, untreated mental health conditions can cause setbacks or relapses in recovery. Medication can act as a preventive measure, reducing the risk of symptoms worsening or returning. This ensures that the work you do in therapy remains sustainable, helping you continue to build on progress over time.

It’s Your Choice, and You’re Not Alone

Combining therapy with medication isn’t a sign of failure; it’s a powerful, evidence-based approach to managing mental health during pregnancy and the postpartum period.  Medication can create the mental space and stability needed to make therapy more effective, while therapy provides the tools and skills to manage emotions and improve overall well-being. Together, they can support you on your journey to better mental health.

Choosing whether or not to take medication during pregnancy or postpartum is a deeply personal decision. But remember: You don’t have to do it alone. Reach out to your healthcare provider, your therapist, and your support network to ensure you're making the best decision for your mental and physical health. Whatever path you take, know that your well-being matters, and there are many options available to support you through this journey.