Hesitancy among pregnant individuals to take selective serotonin reuptake inhibitors (SSRIs) or serotonin–norepinephrine reuptake inhibitors (SNRIs) is common, and is often rooted in fears about potential harm to the developing fetus. Although considerable attention has been given to the risks of in utero exposure to psychotropic medications, less frequently discussed—but equally important—are the potential consequences of untreated maternal depression on offspring mental health. These concerns place clinicians and patients in a difficult position, weighing the known and unknown risks of pharmacologic treatment against the substantial burden of untreated mood and anxiety disorders during pregnancy.