This new pill could help give mothers their joy back after childbirth

A new medication is showing promise in treating patients who suffer from postpartum depression (PPD), a mood disorder that can show up days to months after a person gives birth. On Friday, the pill called zuranolone was approved by the Food and Drug Administration (FDA).

In a Phase 3 trial, funded by the pharmaceutical partners Sage Therapeutics and Biogen, 196 mothers with severe PPD participated and 170 completed it. Half were given zuranolone and half were given a placebo. The health of all the mothers improved, but the ones on the new medication made much more significant strides that continued four and six weeks later, according to the study. 

Long-term effects are not yet known, and it’s not clear if the drug would pose a risk to breastfed babies. Still, a medicine that can specifically treat mothers suffering from postpartum depression is groundbreaking, as this would be the first treatment that mothers can take on their own. Another medication was approved in 2019, but it’s in the form of an intravenous injection—not a pill.

After the pill completes a 90-day review required by the Drug Enforcement Agency, the drug will be marketed under the brand name Zurzuvae, although it’s unclear what it would cost.

The “baby blues” is a common experience for new mothers, one that is characterized by feeling weepy for no reason at all in the days after giving birth. However, postpartum mood disorders that extend past the initial weeks of new parenthood are stunningly common. About one in seven women experience mental health issues that negatively impact their experiences with early parenthood, as well as their ability to care for themselves, in drastic and life-altering ways. 

Depression, sleeplessness, overwhelming anxiety, rage, and feelings of not being able to bond with a new baby are just some of the symptoms that new mothers with postpartum mood disorders may experience. That’s why medication and talk therapy are crucial in helping women experiencing PPD. However, because there are still relatively massive stigmas surrounding mothers seeking treatment after giving birth, and screening is still not what it should be, many new mothers fly under the radar.

Suffering in silence

Women routinely suffer through their sadness silently. Suicide accounts for about 20% of maternal deaths in the first year after childbirth, and up to 14% of women experience suicidal ideation either during pregnancy or postpartum—two statistics that should be frightening.

New medications that can specifically treat postpartum mood disorders are undeniably important—no one can argue with that. However, it’s not simply brain chemistry that leads women to feelings of utter despair after having a baby.

Many of the problems that occur in postpartum are societal issues that don’t seem to be going away any time soon, says Dr. Lucy Hutner, a reproductive psychiatrist in New York City. She says that while “on the one hand, it’s always good when we have good medication options, and particularly good for the known subset of women who are more sensitive to hormonal changes after giving birth” (who, she says, may benefit from this drug the most)—many issues other than biology are at play.

Hutner calls PPD a “human rights and mental health crisis,” which she says impacts marginalized communities the most. That’s because such communities have lower access to mental health care and social support. She adds that postpartum mental illness is the “most common complication” of giving birth in the United States.

She pointed to a statistic that showed the rates of PPD shot up to 35% when women were more isolated during COVID, demonstrating that there is a clear community element to postpartum mental health.

New mothers are all too often forced back to work before their bodies have even had time to heal from delivery, let alone before they adjust to the demands of new parenthood. Families lack support, in terms of paid leave for both mothers and their partners, which Hutner calls “an independent risk factor” of postpartum, but also in terms of policies and protocols that help women succeed at home and at work later on. Women need flexibility, personal days, private areas to pump, and, oh yeah, affordable childcare, which is still massively unavailable to most.

Medications designed to specifically treat postpartum mood disorders are necessary and will certainly save lives, and give new mothers back their joy. But until new moms don’t feel a crushing weight on their backs from policies that don’t support them, postpartum will continue to feel bleak for too many.

Update, August 4, 2023: This story has been updated with information about the drug’s FDA approval.