You cannot power your way through postpartum depression and anxiety. Just look at the statistics. About 29-44% of Black women experience postpartum depressive symptoms. Suicide and overdose are the leading causes of maternal deaths in the first year following pregnancy. While Black women are twice as likely as white women to experience perinatal mood and anxiety disorders (PMADs), they are half as likely to seek or receive care. 

Cierra Murphy Higgs is a lactation consultant and perinatal maternal health advocate. She explains that Black women often wrestle with the pressure to appear strong and resilient. Doing so often prevents them from seeking the help they need, which can lead to untreated postpartum depression. 

“Trying to ‘power through it’ may lead to worsening symptoms and prolong the mother’s suffering,” Higgs said. “Understanding the complexities of perinatal mental health often requires professional intervention and support.” 

Moms, you don’t have to suffer or bear the burden alone. Under the guidance of a medical practitioner or psychiatrist, antidepressants can reduce the effects of anxiety and depression.

Obstacles to Maternal Mental Health Care

Higgs explained that stigma in the Black community further complicates Black mothers receiving proper mental health care. There is a lot of shame surrounding postpartum depression and anxiety, as well the use of antidepressants.

Common concerns about using antidepressants include: fear of harming the baby, fear of being deemed “crazy,” fear of having a child taken from them, facing stigma that relying on medication is a sign of weakness or failure, concern for becoming addicted to medications, misinformation regarding medications’ effectiveness, and concern for medication safety while breastfeeding. 

“It is essential for Black women to receive the support, understanding, and resources for their mental health needs,” she added. “This includes access to culturally-competent mental health services and destigmatizing conversations around mental health in the Black community.”

Black women who seek medical treatment might find it difficult to locate providers who specialize in PMADs and share their racial identity. It is important to note that the current PMAD screening tools don’t assess factors that specifically apply to Black women, Higgs said. Common symptoms for Black women include irritability, self-criticism, and issues within their body like fatigue, insomnia, and reduced libido.

“For Black women, perinatal depression often does not present in ways we ‘traditionally’ view depression,” she added. “So many Black women may not know they are experiencing it.”

Antidepressants During Pregnancy 

Both during pregnancy and postpartum, the decision to use antidepressants should be made in with a healthcare provider who can assess the individual’s unique circumstances. They’ll consider factors such as the severity of symptoms, previous response to mental health treatment, breastfeeding status, and potential side effects. Close monitoring and follow-up care are essential to ensure the safety and well-being of both the parent and the baby.

For pregnant individuals, Higgs explained that it’s essential to balance the potential risks of medication exposure to the fetus with the risks of untreated maternal depression. Untreated depression during pregnancy can have adverse effects on both the mother and the baby. 

In these cases, healthcare providers may select antidepressants that are considered safer options. Research also indicates that untreated PMADs can elevate the risk of preterm delivery. 

Antidepressants Postpartum

Postpartum depression (PPD) is a common and serious mental health condition that can occur after childbirth. For moms dealing with moderate to severe PPD symptoms, antidepressants can be an effective treatment option. They can help reduce symptoms such as persistent sadness, anxiety, irritability, and difficulty bonding with the baby. By improving mood and reducing symptoms, antidepressants can support the mother’s ability to care for herself and her baby. 

Tysha Pittman, owner of Pittman Perinatal Mental Health, explained that creating a postpartum coping plan is an effective strategy to identify and minimize risks. Antidepressants may be part of the plan. 

Treatment plans and effects are on a case-by-case basis. Expectant moms should make decisions with their OB/GYNs. Together, they should consider: the current symptoms, past treatment history, personal and cultural considerations, and familial history.

“What is important to remember is that every baby deserves to have a mother who is the most healthy she can be, and whether it is a psychiatric illness or a psychotropic medication there are risks to be considered,” said Pittman.

Possible Side Effects 

Potential side effects of using antidepressants during and after pregnancy include: nausea or gastrointestinal issues, sleep disruption, appetite and weight gain/loss, mood changes, and withdrawal symptoms. Potential risks to the baby during pregnancy vary depending on the specific medication, dosage, timing of exposure, and individual circumstances. 

Moms and providers should discuss the potential side effects and risks associated with antidepressants before starting or discontinuing medication. When evaluating a medication’s safety, physicians take into account the consequences of not prescribing it. 

“Open, honest communication and regular follow-up appointments are essential for monitoring maternal and fetal well-being throughout treatment,” Higgs said. 

Advice for Moms

Higgs encourages expecting or new moms to seek support from a medical provider who specializes in perinatal mental health. 

She explained that seeking assistance doesn’t necessarily mean an immediate recommendation for medication. While antidepressants can be an effective treatment for postpartum depression or anxiety, they are not the only option. 

“If it becomes necessary for the mother to contemplate medication, she should feel empowered to make a well-informed choice that prioritizes both herself and her baby,” Higgs said. “Recovery from postpartum depression or anxiety is a journey, and it’s okay to take small steps toward healing along the way.”

Pittman encouraged expecting moms to ask a lot of questions and to educate themselves. 

“Treatment with medication is not an easy decision, but there are well-studied medications that have favorable perinatal safety profiles,” she added. “Lean on your support circle and share your concerns with them.”