When Policy Ignores Mothers: Why Evidence-Based Maternal Mental Health Care Matters
“Maternal mental health is not a luxury. It is the foundation of generational wellbeing—and when policy ignores mothers, it abandons the future.” - Mary Coughlin
When Policy Ignores Mothers: Why Evidence-Based Maternal Mental Health Care Matters
The recent FDA panel on SSRIs in pregnancy revealed something deeply concerning: maternal mental health was treated as secondary to fetal outcomes. The tone of the discussion—and the broader direction of messaging from the Department of Health and Human Services (HHS)—signals a dangerous shift away from science-based, patient-centered care.
As advocates, clinicians, and parents, we cannot ignore what is happening. When ideology outweighs evidence, mothers, babies, and families pay the price.
What Happened at the FDA Panel?
The panel focused heavily on the potential risks of SSRIs for the fetus, while giving minimal attention to the equally real risks of untreated maternal depression and anxiety. There was little acknowledgement that:
Perinatal mood and anxiety disorders are the most common complication of pregnancy.
Untreated maternal mental health conditions increase risks of preterm birth, poor bonding, and even maternal mortality.
Scientific guidelines (ACOG, APA) recommend SSRIs as a first-line option for moderate-to-severe perinatal depression and anxiety when clinically indicated.
This imbalance in the discussion perpetuates stigma, fear, and misinformation—leaving women without full, informed access to care.
Why This Matters
Maternal mental health is not optional. It is foundational to the health and wellbeing of both mother and baby. Untreated depression and anxiety in pregnancy can themselves be forms of early life adversity, shaping a child’s brain and lifelong health.
When HHS platforms discussions that minimize maternal wellbeing, we risk reinforcing a culture where women’s voices and agency are sidelined—where decisions about treatment are driven more by ideology than by science, compassion, and lived experience.
Evidence vs. Ideology
Leading organizations, including the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA), have been clear:
SSRIs are first-line pharmacotherapy for moderate-to-severe perinatal depression and anxiety.
Treatment decisions must be grounded in shared decision-making—with full discussion of both the risks of treatment and the risks of leaving mental health conditions untreated.
When policymakers or panels ignore this guidance, they are not being cautious—they are being dismissive of maternal health and autonomy.
What We Can Do
We must demand that public health messaging honors both evidence and lived experience:
Amplify voices like Adrienne Griffen and the Maternal Mental Health Leadership Alliance (MMHLA). They remind us that caring for a mother’s mental health is caring for her baby.
Share accurate, evidence-based information. Misinformation about SSRIs—and maternal mental health more broadly—causes real harm.
Advocate for trauma-informed, patient-centered policies. Maternal wellbeing is not negotiable.
A Final Word
When maternal mental health is sidelined, we all lose. The wellbeing of mothers and babies is intertwined. We must challenge any narrative that pits them against each other.
Our call to action is clear:
Speak up.
Share evidence-based resources.
Support organizations fighting for maternal mental health equity, like MMHLA.
Because every mother deserves care that is informed, compassionate, and rooted in science—not ideology.
Take care and care well,
Mary
