Depression during pregnancy, or prepartum depression, is a common condition that an estimated ten percent of women in the United States experience. The development of selective serotonin reuptake inhibitors (“SSRI”) offered pregnant women hope in the form of a pill they can take to reduce or eliminate their depression symptoms. However, various medical studies dating back to 2013 found that mothers can experience serious complications from taking SSRIs during childbirth. Recently, many manufacturers of well-known depression medications have added to their existing warnings about postpartum complications from antidepressants, including the possibility of post-partum hemorrhaging.
If you or your spouse recently experienced postpartum hemorrhaging after taking an SSRI during the third trimester, it’s possible that your hemorrhaging was caused or made worse by the antidepressant drugs. Unfortunately, manufacturers of most SSRIs failed to disclose the risk of postpartum hemorrhaging while taking SSRIs until very recently, depriving you and your doctor of critical information. While the link between SSRIs and post-partum hemorrhaging is still under investigation, those who experienced post-partum hemorrhaging after taking an SSRI may be able to pursue a product liability claim against the drug’s manufacturer. To see our recent post on the topic, click here.
Is There a Connection Between SSRI Use and Post-Partum Hemorrhaging?
Yes, there is a connection between certain antidepressants and childbirth complications. This is not a new development, as it’s been known for some time that certain antidepressant medications, including some SSRIs, can cause birth defects because the medication can pass through the mother’s blood and into the fetus’. However, aside from the risk of birth injury, there is also a risk of postpartum complications from antidepressants, most notably post-partum hemorrhaging.
What Is Postpartum Hemorrhaging?
Postpartum hemorrhage (PPH) refers to excessive bleeding after childbirth. While "hemorrhaging" and "bleeding" both refer to the loss of blood from the circulatory system, they are used in different contexts and carry different connotations regarding the severity of the blood loss. In fact, postpartum hemorrhaging is one of the leading causes of maternal death worldwide. So, while all hemorrhages involve bleeding, not all bleeding is classified as a hemorrhage. The term "hemorrhaging" conveys a sense of urgency and severity that "bleeding" doesn't necessarily imply on its own.
There are two main types of postpartum hemorrhage:
Primary (or immediate) PPH: This occurs within the first 24 hours after birth.
Secondary (or delayed) PPH: This occurs between 24 hours and six weeks postpartum.
The symptoms of either type of postpartum hemorrhaging include:
- Heavy vaginal bleeding (soaking more than one sanitary pad per hour);
- Larger than usual blood clots;
- Rapid heartbeat;
- Low blood pressure;
- Dizziness or fainting;
- Pale or clammy skin; and
- Pain or swelling in the vagina or perineum.
Were SSRI Manufacturers Aware of the Risk of Postpartum Hemorrhaging?
Based on the availability of evidence supporting a link between taking SSRIs and postpartum hemorrhaging, it appears very likely SSRI manufacturers were aware of the risks. Moreover, recently, several major manufacturers of SSRI antidepressants added language to their products’ existing warnings informing patients about the risk of postpartum hemorrhage due to SSRI medication. However, it is unclear why these manufacturers have now decided to add such a warning, especially in light of the fact that the risks have been well-known for over a decade.
Pregnancy and SSRI Safety
All SSRI manufacturers include warnings on the medication’s label, informing women who are or may become pregnant to consult with their doctor before taking an SSRI medication. That said, there is not currently, nor has there ever been, an SSRI pregnancy black box warning from the FDA. A black box warning is the most serious type of warning the FDA can issue, short of banning a medication altogether.
Indisputably, prepartum depression is a serious condition that should be addressed. Women experiencing prepartum depression face very real risks, and they should seek treatment. SSRI medications are effective for many pregnant women at reducing the symptoms of depression. This is why doctors, most of whom are aware of some of the risks, often prescribe SSRI medication during pregnancy. However, the burden still rests with the drug manufacturer to issue warnings on the drug’s label.
In short, the decision whether to take any medication during pregnancy is an individual choice that should only be made after consulting with a doctor. Doctors will discuss the possible risks of taking the medication, such as postpartum hemorrhaging, versus the risk of not taking the medication and allowing the symptoms of depression to go untreated.
Is There a Lawsuit for SSRI-Caused Hemorrhaging?
Currently, there are several personal injury, product liability and medical malpractice law firms looking into the possibility of an SSRI lawsuit for pregnant women who experienced hemorrhaging after taking SSRIs during the final months of pregnancy. These lawsuits could proceed on one of several theories.
Product Liability Claims Against the Manufacturer of SSRI Antidepressants
First, the manufacturer of an SSRI medication may be liable for failing to warn pregnant women about the known risk of hemorrhaging. As a general rule, manufacturers, including pharmaceutical companies, have a legal duty to inform patients about all known risks associated with their products. Not only that, but manufacturers must put their products through rigorous testing to uncover possible side effects and complications.
Medical Negligence and Antidepressants In Pregnancy
Second, doctors may be liable under a theory of medical malpractice if it can be shown that they knew or should have known about the risks of SSRIs during pregnancy but failed to inform patients of the risks.
However, both product liability and medical malpractice cases are exceedingly complex. Therefore, women who took an SSRI during pregnancy and subsequently experienced postpartum hemorrhaging should consult with an experienced SSRI pregnancy lawyer to learn more about their rights and how to effectively pursue a claim against the manufacturer, their doctor, or both.
