Does anyone know if taking antidepressants in third trimester changes risk status?

[Onebirthplaneveryminute]

I have been diagnosed with OCD at 28 weeks pregnant on dc2. I have actually probably had it since my early 20's on and off but it is worse in pregnancy for me.

Consultant psych has prescribed sertraline 50mg. When talking through the risks, he said that there have been some studies indicating an increased risk of pulmonary hypertension in neonates exposed to sertraline, but there isn't enough evidence at present to change the guidance.

I am wondering - but forgot to ask - would taking meds mean I was no longer viewed as low risk for labour and would rule out waterbirth etc?

I am trying to weigh up costs/benefits here as I know that untreated anxiety disorders in the third trimester are pretty bad for babies too and there isn't CBT available at present and have no clue how to go about private stuff...

Any thoughts welcome.

I can't speak about the medication you're taking. My daughter was born six months ago after a dreadful pregnancy during which I took codeine painkillers, sleeping pills and low dose antidepressant. We had no idea what state she'd be in and a specialist was ready at the C-section. It turned out there was no reason to worry. She was on the Apgar rating and there's never been a more settled, normal baby! I thought that might go some way to reassure you as it can be a frightening time.

Sorry, meant to say a 9 on the Apgar rating.

I took Prozac for whole of my pregnancy with DS3 and he was absolutely fine (he's now 5). I had a home birth as well and don't think that anyone ever said that there was a higher risk so that I would have to go to hospital. I lowered the dose before he was born so that there was less of a risk of withdrawal symptoms for him (on advice of consultant). Everything went well and luckily didn't have any problems.

Hope that helps and good luck!

If you want a waterbirth you should talk to one of the senior midwives. I would have thought that a hospital waterbirth might be reasonable if you wanted a paediatrician nearby in case of rare neonatal complications. Sertraline won't affect your ability to deliver normally.

I am on 150mg of sertraline for PND-OCD & regular OCD and am pg with DC4 - sertraline wasn't one of the needed to know drugs list when my booking-in was done (list of drugs that may be tetragenic or cause complications).

I was on 100mg when pg with DD2 & DD3 and no one mentioned any (further) raising of risks for the pgs. In fact I had a planned HB for DD2 and a planned HB but transferred in labour due to mec. for DD3. Neither one had any special tests or checks and I am still bfing then both so it's definitely compatible with bfing too (just in case you want to bf and you get told it's not compatible).

I'm on low dose (only 10mg) citalopram for depression, started taking them at about 34w. I was originally told I needed a cardiac scan because of it by my community midwife, but then she checked and was told that there was no need in the third trimester.

I'm booked in for a homebirth, so def still considered low risk :)

By the way, you might want to look into the risks of drug interaction with pethadine that I found after playing with google that my GP didnt mention (possible increased risk of serotonin syndrome if taken together).

Not sure of exact details as I'm hoping to rely on G&A only again, but something that might be relevant to you

I'm on sertraline (pg with DC2) and was on it with DD too. I wasn't allowed on the low risk midwife led unit, but could use the pool for delivery in the consultant led unit.

This time I've tried to get onto the MW unit. Obstetrician is totally happy as he says the (very low risk) is after the birth, so I could be transferred onto the maternity ward afterwards for neonatal obs. However, it is up to the MW's, who said no. Hoping the pool will be free this time!

I have received a letter this time too requiring me to stay in hospital 48 hours after the birth for obs.

Oh - and all fine with DD. No withdrawal, no issues, and I breast fed successfully for 16 months.

Good luck and congratulations!

Thanks for your feedback everyone. Going to speak to midwife on Weds and make a decision about meds at this stage then, my understanding is I should be offered CBT first and meds are being given as there isn't capacity for this - feel I will consider CBT privately if meds are going to interfere with birth because of local policy, otherwise I will go with them. Thanks!