For years, many pregnant women have faced a difficult choice: continue antidepressant medication and risk causing harm to the baby, or discontinue treatment and try to survive alone. According to new studies, halting may pose a higher threat. The "protection paradox" is the term used by experts to describe this concerning phenomenon. 

According to data presented at the Society for Maternal-Foetal Medicine (SMFM) 2026 Pregnancy Meeting™ in Las Vegas, pregnant patients who stopped taking antidepressants were nearly twice as likely to have a significant mental health emergency as those who continued medication.

Researchers at the University of Pennsylvania examined de-identified insurance records from Independence Blue Cross for 3,983 individuals who gave birth between January 1, 2023, and December 31, 2024. All had been diagnosed with depression or anxiety before pregnancy and were now taking an SSRI or SNRI antidepressant three months before conception. 

SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin norepinephrine reuptake inhibitors) are medications that assist in regulating brain chemicals associated with mood. They are widely used to treat depression and anxiety. 

The study discovered no difference in emergency or outpatient mental health visits before pregnancy between women who continued their medication and those who quit. However, while pregnant, those who stopped therapy had a nearly twofold increased risk of mental health emergencies, such as suicide, substance abuse, and psychosis. 

Two "danger zones" appeared. The first rise happened in the first month of pregnancy, most likely when women abruptly stopped taking their medications after realising they were pregnant. The second peak occurred in the ninth month, when physical strain and worry about labour increased. 

Is it safe to use antidepressants when pregnant? The available research suggests that SSRI usage is not linked to congenital abnormalities, poor foetal growth, or long-term developmental issues. Can SSRIs cause birth defects? Current large-scale data do not indicate a consistent connection. 

What happens if an antidepressant is suddenly stopped while pregnant? Sudden discontinuation can cause a recurrence of depression or anxiety. In severe circumstances, this can result in suicide ideation, overdose, or psychotic episodes. 

Can untreated depression harm a baby? Experts warn that untreated or undertreated depression can result in premature birth, low birth weight, and preeclampsia, a dangerous blood pressure issue. When is the risk at its maximum during pregnancy? This study clearly identifies the first and ninth months as important periods for attentive monitoring. 

"These findings, while not entirely surprising to those who work with pregnant patients suffering from mental health conditions, are so important to consider for maternal health policy," said lead researcher Kelly B. Zafman, MD, MSCR, a maternal-foetal medicine fellow at the Hospital of the University of Pennsylvania. "This study emphasises the need of prioritising pregnant patients' mental health and providing a comprehensive range of treatment choices, including drugs where clinically appropriate. Confronting the maternal mental health epidemic is critical for lowering maternal morbidity and death in the United States." 

Mental health issues are increasingly regarded as the primary cause of maternal mortality in the United States. However, public health messaging has mainly concentrated on avoiding alcohol and tobacco, sometimes producing a blanket panic around all medicines—a characteristic some experts refer to as "teratogen anxiety," which means excessive concern that a substance can harm the foetus. 

The findings reflect a bigger system issue: mental and obstetric care are frequently delivered separately. Researchers advise that insurers use prescription data to identify pregnant women who abruptly discontinue antidepressants in the first trimester and initiate early outreach. 

The basic message is clear. Protecting the mother's mental health is inextricably linked to protecting the infant. A good pregnancy depends on a healthy mother, both physically and psychologically.