Roseann Gumina, M.D., is an obstetrician/gynecologist in private practice in Milwaukee, Wisconsin. Like most OB/GYNs, Dr. Gumina sees more pregnant women on antidepressants in a given year than most psychiatrists are likely to see in a lifetime, and her perspective is informative.

“Generally, most women who have been on SSRIs will have already discontinued them on their own the minute they found out they were pregnant, so when I see them for their first pre-natal visit, my task is to elicit the history and try to assess the risk of not taking medication. In uncomplicated situations, I won’t normally get a psychiatrist involved. For example, a common scenario is that the patient was started on an SSRI by the primary care doctor for a mild depression or for PMS, and in these cases I don’t recommend re-starting it. But if the patient has a history of severe depression with suicidal ideation, I usually suggest they resume medication. Actually, I’ve found that patients who take SSRI’s for panic disorder are the ones who are most likely to ask to resume it, because their anxiety often worsens during the pregnancy.