that is so irresponsible. if you are on anti-depressants, or are depressed, you should hold off on becoming a parent. if you can't even take care of your own emotional well being properly, why the hell are you reproducing? can't having a kid wait until your mental health is in order? what ever happened to this piece of common sense advice?

i'm not saying that normally happy women don't get depressed when pregnant, or post pregnancy. but if you are already depressed and medicated, why get pregnant? pregnancy and parenthood is only going to add stress, which can exacerbate depression.

i guess i'm not feeling too much sympathy for depresseed medicated women who choose to get pregnant. i mean, you're not fit to be a parent if you don't have your emotions in order. i'm not saying parents are supposed to be perfect, or that they can never have weak moments--but if you're so fragile that you need meds, you're obviously too fragile emotionally to be providing emotional support to another vulnerable being--and that's what children are. their needs come before yours. but if you're depressed, you have to take care of your needs first before you can take care of anyone else's.

i'm going to be super crass here--but if you are on meds and got pregnant on purpose, fuck you. i don't care if your meds might harm the fetus, you shouldn't be fucking pregnant anyway. take care of yourself first before you bring another human into this world and screw the kid up with your "baggage". that's the responsible thing to do.

I was about to make the same ranting point as MaryJane76. I'm glad somebody else beat me to it, I couldn't have said it better myself.

No one would say that you shouldn't have a child if you're suffering from diabetes, but people just don't feel the same guilt about passing judgment on depressed women. I guess diabetes is a REAL illness, while depression is just weak women who "don't have their emotions in order."

As for the new studies, the first, that babies have withdrawal symptoms. You mean that the baby might be grumpy? That, I can deal with. The second, that SSRI's can double the rate of lung disorders from 3 in 1,000 to 6 in 1,000, is such a minor risk that only the people getting the most marginal of relief from anti-depressants should be taken off medications.

I'd suggest that Maryjane76 educate herself about depression. Andrew Solomon's book "The Noonday Demon" contains some great explanations, personal experiences, and historical and social analyses of depression.

For many women, depression is a chronic illness. It's not something you "catch" after a bad breakup and chase away with enough pieces of chocolate cake and bubble baths. For some people, staying on meds is a life-long commitment, the same as staying on heart medication or taking insulin injections is for others. It means the difference in being able to love and laugh and live normally or in being non-functional.

And that's the catch - people who have not been seriously depressed think of medication as "better living through chemistry," but really the case is "normal living through chemistry." As far as being able to tend to one's own emotional well-being, that's exactly what people are doing by choosing medication. People aren't sitting around weeping and deciding it's a good idea to go get pregnant, they are living normal productive lives with a managed medical condition. There's a huge difference.

No mother wants to put her child in danger. We get conflicting information on what is and what isn't safe, and it does put women and their partners in a very awkward place. Risk the health and safety of the mother? The possible health of the child? Go without having children when you desperately want one and are able to care for one? None of these options are good ones. It's something people must weigh out for themselves, and it can be a very painful process, even without the judgment of others who don't understand the situation.

Whenever we start prattling on about who is and who is not allowed to reproduce, it's a damn slippery slope.

Based on your logic, you shouldn't be reproducing either, because someone so draconian and unsympathetic likely wouldn't be the best nurturer of children.

Good thing your type of logic went out vogue with the Nazi party.

For those who are interested, the complete text of the article can be found at the NEJM website, here:

http://content.nejm.org/cgi/content/full/354/6/579

Two caveats are worth noting to the study's alarming-sounding findings:

1. As the researchers note, the increased risk of PPHN occurs after the 20th week of pregnancy; from fertilization to 20 weeks, there was no difference in PPHN rates between SSRI-taking moms and non. At the very least, women with clinical depression should feel fine about continuing to take their SSRI's for the first half of their pregnancies.

2. The researchers conclude in their final paragraph:

On the assumption that the relative risk of 6.1 for PPHN observed in our study is true, and that the relation is causal, the absolute risk among those who use SSRIs late in pregnancy is relatively low (about 6 to 12 per 1000 women); to put it in other terms, about 99 percent of women exposed to one of these medications late in pregnancy will deliver an infant unaffected by PPHN.

While a doubled increase in risk sounds scary, in this case it's only raising the risk from infinitesimal to very, very tiny.

Maryjane suggests that no woman should even consider conceiving until she has her "emotions under control." Unfortunately, for many women (and men), medication is a vital part of that control. I know many, many people (including myself) diagnosed with clinical depression who are simply not able to function consistently without their meds. It's not the emotions, it's the faulty neurochemistry. Psychotherapy and behavior modification have helped everyone I know tremendously, and for many depressed people they're all that's needed to bring everything back to an even keel, but for some of us it just isn't enough, any more than diet modification and exercise are enough for a large number of otherwise healthy diabetics.

Most of the clinically depressed people I know are strong and smart and have worked like hell to get to the point where a single medication is all they need to keep themselves healthy. And most of the clinically depressed people I know are parents, and damned good ones. They had healthy pregnancies and bore healthy babies who have grown into fine children; those children have benefitted all the more from having parents who know the dark and terrifying places and have compassion for those caught in them, and I'm absolutely confident that those children are going to grow into kind and compassionate adults.

To reiterate: the absolute risk among those who use SSRIs late in pregnancy is relatively low (about 6 to 12 per 1000 women); to put it in other terms, about 99 percent of women exposed to one of these medications late in pregnancy will deliver an infant unaffected by PPHN. Maryjane is entitled to her opinion, but I don't believe the numbers justify it.