When the U.S. Food and Drug Administration (FDA) convened a public expert panel to review the use of selective serotonin reuptake inhibitors (SSRIs) during pregnancy, it re-opened a long-standing and highly charged conversation. At the center of the debate: how to weigh the risks of antidepressants to fetal development against the dangers of untreated maternal depression.With no clear outcome or regulatory shift announced at the end of the meeting, the session highlighted just how divided experts remain over SSRIs—a class of drugs that includes some of the most commonly prescribed medications in the U.S., such as Prozac, Lexapro, and Zoloft.The FDA forum, led by Commissioner Dr. Marty Makary, brought together perinatal psychiatrists, developmental biologists, epidemiologists, obstetricians, and mental health clinicians. The focus? Whether SSRIs prescribed during pregnancy need stronger warnings, including a potential “black box” label—the FDA’s most serious caution.Dr. Makary opened the session with a sobering observation: nearly one in four middle-aged American women is on an antidepressant, and approximately 5% of pregnant women are prescribed SSRIs. Despite the increasing use of these drugs, he pointed out that the broader mental health picture in the U.S. hasn’t improved. “The more antidepressants we prescribe, the more depression there is,” he said, urging a deeper look at root causes instead of pharmaceutical fixes alone.Nine of the ten panelists had previously voiced public concerns about SSRI safety or expressed skepticism toward antidepressant efficacy. Many cited studies indicating potential neurodevelopmental risks in babies exposed to SSRIs in utero. These include associations with autism spectrum disorders, ADHD, and other cognitive challenges.However, these claims were not universally accepted. Independent researchers and clinicians noted that several of the studies referenced lacked proper controls, making it difficult to determine whether adverse outcomes were caused by the medications, the underlying depression itself, or other unrelated factors like maternal stress, environmental exposures, or socioeconomic influences.Critically, many of the panelists underemphasized—or ignored entirely—the well-documented risks of untreated perinatal depression. Suicide remains one of the leading causes of maternal death in the first year postpartum. Depression during pregnancy has also been associated with premature birth, low birth weight, and impaired bonding with the baby.There’s no question SSRIs, like any medication, carry risk. But context matters. SSRIs aren’t prescribed casually; they’re part of a personalized treatment plan that often includes psychotherapy, lifestyle interventions, and close monitoring.Experts caution against blanket restrictions or alarmist warnings. While acknowledging the importance of ongoing research and transparency in labeling, several physicians worry that exaggerated claims could have unintended consequences—mainly, deterring pregnant women from seeking care.“We need to be careful not to scare patients away from treatment that might be lifesaving,” said one perinatal psychiatrist unaffiliated with the FDA panel. “Depression doesn’t disappear during pregnancy. For many women, it gets worse.”The debate over SSRIs isn’t happening in a vacuum. It’s unfolding against a backdrop of shifting political narratives around mental health, medication, and government oversight.Robert F. Kennedy Jr., now Health and Human Services Secretary under former President Trump, has been a vocal critic of SSRIs and other psychiatric medications. His “Make America Healthy Again” initiative frames SSRIs as part of a broader pharmaceutical overreach. He’s even gone so far as to claim a link between antidepressants and school shootings—an assertion for which no scientific evidence exists.During the FDA panel discussion, one participant echoed Kennedy’s alarmist rhetoric, declaring, “Never before in human history have we chemically altered babies like this.” Comments like these, healthcare professionals argue, blur the line between evidence-based discussion and ideological fearmongering.The reality on the ground is more nuanced. Clinicians treating pregnant patients with depression must weigh competing risks with every prescription. Factors like a woman’s mental health history, her past response to medications, current symptoms, support system, and overall health are all taken into account.Many OB-GYNs and psychiatrists recommend continuing SSRIs during pregnancy if the patient has a history of severe depression or has responded well to the medication. The cost of relapse—both emotionally and physically—can be high. In contrast, women with milder symptoms might consider tapering off or trying non-drug therapies under medical supervision.And while some studies suggest a possible association between SSRI use and neurodevelopmental issues in children, the evidence is not conclusive. In many cases, what appears to be a risk may be confounded by the effects of the illness itself.Despite the heated debate, the FDA did not announce any immediate regulatory action following the panel meeting. An agency spokesperson emphasized that the session was part of “broader efforts to apply rigorous, evidence-based standards” in evaluating drug safety, particularly during sensitive periods like pregnancy.Still, the session underscored a growing demand for more nuanced research and improved labeling that fully informs patients without generating unnecessary fear. The agency’s next steps remain unclear, but stakeholders on all sides agree: this is a conversation that’s far from over.Can SSRIs Harm Unborn Babies?The question of whether selective serotonin reuptake inhibitors (SSRIs) can harm unborn babies is complex—and not definitively answered. SSRIs are widely prescribed to manage depression and anxiety, including during pregnancy. But recent scrutiny by an FDA advisory panel has reignited concerns about their safety, particularly in the first trimester when fetal development is most vulnerable.Studies over the years have linked SSRI use in pregnancy to a small but possible increased risk of complications such as low birth weight, premature birth, neonatal adaptation syndrome (withdrawal-like symptoms in newborns), and persistent pulmonary hypertension of the newborn (PPHN). Some data even suggest a potential link between early SSRI exposure and neurodevelopmental issues, including autism spectrum disorders, though these findings are inconclusive and often confounded by the severity of maternal depression itself.On the flip side, untreated depression during pregnancy also carries serious risks—for both mother and child. It can lead to poor prenatal care, higher rates of substance use, inadequate nutrition, and increased risk of suicide or self-harm. These factors can impact fetal outcomes as well.As public health agencies and professionals continue to assess the benefits and risks of SSRIs during pregnancy, one thing is clear: blanket judgments and politicized narratives don’t help patients. What pregnant individuals need is clear, evidence-based guidance—and compassionate, personalized care that prioritizes both maternal and fetal health.The question of whether selective serotonin reuptake inhibitors (SSRIs) can harm unborn babies is complex—and not definitively answered. SSRIs are widely prescribed to manage depression and anxiety, including during pregnancy. But recent scrutiny by an FDA advisory panel has reignited concerns about their safety, particularly in the first trimester when fetal development is most vulnerable.Studies over the years have linked SSRI use in pregnancy to a small but possible increased risk of complications such as low birth weight, premature birth, neonatal adaptation syndrome (withdrawal-like symptoms in newborns), and persistent pulmonary hypertension of the newborn (PPHN). Some data even suggest a potential link between early SSRI exposure and neurodevelopmental issues, including autism spectrum disorders, though these findings are inconclusive and often confounded by the severity of maternal depression itself.On the flip side, untreated depression during pregnancy also carries serious risks—for both mother and child. It can lead to poor prenatal care, higher rates of substance use, inadequate nutrition, and increased risk of suicide or self-harm. These factors can impact fetal outcomes as well.SSRIs aren’t inherently harmful, but their use during pregnancy must be carefully evaluated. For some, the benefits outweigh the risks—especially when mental health is at stake. Always consult a healthcare provider for personalized guidance.