Not Always 'the Happiest Time'

At the same time, no one would argue that antidepressants are good for growing fetuses. Two new studies help people assess the risks for themselves. In one, published in The New England Journal of Medicine, researchers found that newborns whose mothers took Prozac, Paxil or Zoloft in the third trimester had six times the risk of persistent pulmonary hypertension, a rare blood-pressure condition that is potentially fatal. In another, smaller study, 30 percent of infants whose mothers took SSRIs showed symptoms of neonatal abstinence syndrome, a kind of supercrankiness linked to withdrawal. Most got better within days.

Therapy is a good alternative, especially for women with mild or moderate symptoms. In today's world, where families live far apart and everyone works all the time, many pregnant women say they feel isolated. This can be alleviated by talking. Margaret Spinelli, a psychiatrist at Columbia University, was surprised to find in a 2003 study that depressed pregnant women had a 60 percent recovery rate with interpersonal psychotherapy, a short-term, focused treatment--about the same rate as with antidepressants. "We just don't have the networks of close-by girlfriends and sisters and neighbors and moms that provide support," adds Pittsburgh's Wisner.

One of the reasons Marlo Johnson kept her depression hidden was that she didn't want to take antidepressants during her second pregnancy, as she had during her first. "I don't like being on medication; I kept telling myself I could handle it," she says. But finally Johnson's doctor took action. She ordered her to take a leave from work and to come clean with her therapist; Johnson's husband, who was working hundreds of miles away, came home. On March 20, Carter Patrick Johnson was born, weighing more than eight pounds. Mom says she loves the baby, "but I'm still depressed," and is back on medication. Sometimes even happy stories have bittersweet endings.

With Joan Raymond

© 2006