Apparently all of the SSRI's except for Paxil are "Category C" with an unclear caveat regarding the 3rd trimester related to the risk of persistent pulmonary hypertension to the fetus/newborn. Please tell me how you approach this. When an antidepressant is indicated what is your first choice (and presuming that the mother will be breastfeeding) ? Once you decide upon an antidepressant, are you concerned with specific trimesters or dosage-dependent risks? I had once thought that if an antidpressant was indicated, that Prozac was the way to go given it's extensive track record and long half life (hence minimizing newborn withdrawal effects). However, it seems that nowadays Ob-Gyn's rx/suggest Zoloft without significant concern.