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Reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Pregnancy is often a joyous experience — but it’s also full of changes and unfamiliarities. Your body is shifting, you’re experiencing a range of moods, and there are many temporary restrictions you’ll need to navigate.
On top of all this, growing your family means your life is going to change in a big way. And while you may be happy about that, it can also bring on feelings of nervousness or exacerbate anxiety, especially if you already struggle with chronic stress or anxiousness.
An estimated half-million pregnant women in the United States either have a psychiatric condition or will develop one while pregnant. And when it comes to anxiety specifically, one study found that nearly 10 percent of those with a history of depression or post-traumatic stress disorder (PTSD) will experience generalized anxiety disorder during their pregnancy.
One of the most common ways to treat anxiety symptoms is with anti-anxiety medications. But are they safe for your unborn baby? That’s the big question we’ll answer below.
To understand what anxiety medications are okay during pregnancy, you first need to have a basic understanding of what anxiety medications are.
When it comes to anxiety medications, there are a few different types. Some of the more common options include:
Selective serotonin reuptake inhibitors (SSRIs). Also used for depression, SSRIs work by increasing the brain’s main mood regulator, serotonin. Sertraline and citalopram are among the most commonly prescribed SSRIs.
Benzodiazepines. This type of medication is generally prescribed on a short-term basis. It calms the nervous system, helping to ease anxiety and panic disorder symptoms. Alprazolam is one common example of benzodiazepine.
Now that the different types of anxiety medications have been established, let’s discuss which ones may be safe to take during pregnancy.
With the lowest overall risks associated with prenatal use, SSRIs tend to be the more favorable option for pregnant women with anxiety.
That said, it’s impossible to say whether any anti-anxiety medication taken during pregnancy is completely safe. An estimated 30 percent of babies born to mothers who took SSRIs have neonatal adaptation syndrome, potentially causing jitters, irritability and respiratory distress. It’s not fully known why this happens.
And while that does sound scary, it’s important to note that untreated mental illnesses can also be hard on a pregnancy — for both the mother and baby.
Anxiety may increase the risk of preterm birth, low birthweight or a smaller head circumference.
As mentioned above, it’s hard to say any anxiety medication is entirely safe during pregnancy — though SSRIs are thought to be the best option.
As for medications you should absolutely stay away from? That’s complicated too.
Case-control studies done some time ago found that babies exposed to benzodiazepines in utero faced an increased risk of a cleft lip and cleft palate. Other older studies found that benzodiazepines could cause major malformations in babies or something called benzodiazepine syndrome (which is similar to fetal alcohol syndrome).
Again, this is where the expertise of a healthcare provider comes in handy. They can help you explore different treatment options for your mental health condition and pregnancy.
Some of the most common risks and adverse effects associated with taking anxiety medications during pregnancy have already been covered. For example, taking SSRI antidepressants during pregnancy could lead to neonatal syndrome.
SSRIs may also put a newborn at an increased risk for pulmonary hypertension, though the risk is thought to be extremely low.
We mentioned earlier that taking a benzodiazepine while pregnant could possibly put a baby at risk for birth defects like a cleft palate. Additionally, taking benzodiazepines shortly before giving birth has been associated with floppy infant syndrome, which may involve hypothermia, lethargy, respiratory issues and feeding problems.
We want to reiterate that dealing with an untreated mental illness like anxiety while pregnant can affect both you and your baby. In a review of the effects of anxiety during pregnancy, psychiatric illness was found to have a potentially serious impact on the unborn child as well as the pregnant person.
Anxiety could increase the risk of pregnancy loss during the first trimester. In the second and third trimesters, it can lead to low birth weight and increased activity in the hypothalamic-pituitary-adrenal axis.
There may also be a higher risk of the child developing emotional problems, hyperactivity disorder and cognitive development issues. Further, untreated anxiety during pregnancy could lead to poor mother-child bonds.
As you can see, having anxiety symptoms while pregnant can be detrimental to both woman and child. To avoid these adverse events, it’s worth speaking with a healthcare provider about low-risk antidepressant medications that work for anxiety.
Whether it’s bipolar disorder or depression during pregnancy, dealing with any psychological disorder when expecting can be challenging.
The same is true of severe anxiety and more moderate anxiety disorders. These mental health conditions can drastically impact your daily life and lead to adverse events.
Taking anti-anxiety medication is one treatment option during pregnancy. But are these types of medications safe for you and the baby?
Nothing is 100 percent free of risk. Having said that, many healthcare professionals will tell you that SSRIs can be safe to take during pregnancy.
As for the risks? Some studies indicate higher chances of birth defects with certain anxiety medications, and some are associated with other fetal and infant concerns.
Still, this doesn’t mean anti-anxiety medication should be totally off the table. As noted, untreated anxiety can also be harmful to the mother and baby, potentially leading to adverse pregnancy outcomes.
If you’re expecting, it’s best to speak with a healthcare provider about medications that may be safe to take. They’ll talk to you about the risks and benefits of various medications and what anxiety treatment may be right for you.
Connect with a mental health professional at Hers today.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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