A Joint Statement on the Use of Selective Serotonin Reuptake Inhibitor (SSRI) Medications for Mental Health During Pregnancy
Published Aug 8, 2025
Issued by the Missouri Department of Health and Senior Services, the Missouri Section of the American College of Obstetricians and Gynecologists, the Missouri Pregnancy-Associated Mortality Review Board and the Missouri Perinatal Quality Collaborative
In Missouri, we are united in our work to prevent the leading cause of maternal mortality, perinatal mental health disorders (PMHDs).
The most recent Missouri PAMR report found that mental health concerns were the leading cause of pregnancy-related death for Missouri mothers. The PAMR Board determined that one hundred percent of these deaths were preventable.
According to Postpartum Support International, research and clinical experience have shown that PMHDs can be successfully treated. Behavioral health medications are a vital part of comprehensive mental health treatment. When used appropriately, these medications can improve outcomes for both mother and baby.
When PMHDs go unrecognized or untreated, the consequences can be serious. Maternal death reviews in Missouri have shown that stopping, altering, or inadequately treating mental health conditions during pregnancy can contribute to poor outcomes.
“Untreated perinatal mood and anxiety disorders are not benign. There are multiple effective treatments including psychotherapy and medication. There is substantial evidence that a lack of treatment increases the risk for adverse obstetric outcomes, including small-for-gestational-age infants, preeclampsia, and other hypertensive disorders of pregnancy. Furthermore, untreated depression and anxiety negatively impact maternal-infant bonding, infant development, and long-term child emotional and behavioral health. Critically, untreated perinatal mental health disorders are strongly associated with increased risk of suicide and infanticide—the most devastating and preventable outcomes,” says PAMR Board Chair, Dr. Traci Johnson, MD, FACOG.
We urge all prescribing providers and those who serve mothers, infants and their families to educate themselves on the evidence for mental health treatment during pregnancy and to understand approved prescribing practices. Further, we urge all serving this population to fully understand the critical role that mental health screening, diagnosis, and treatment during pregnancy and the postpartum period hold in the health and well-being of mothers, infants and families.
Missouri has resources to support providers, their teams and patients. The Maternal Health Access Project (MHAP) offers same-day provider-to-provider consultations with a team of perinatal psychiatrists, care coordination support for patients, and education and training materials on a wide range of topics related to perinatal mental and behavioral health. For more information, visit https://mochildwellbeing.org/mhap/.
More resources for providers can be found with the Missouri Perinatal Quality Collaborative at https://mopqc.org/.
If you are pregnant or have just had a baby, help is available. The National Maternal Mental Health Hotline is free, confidential, and here to help, 24/7 at 1-833-TLC-MAMA or https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline.
The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have also released statements on the use of SSRIs during pregnancy.