Our patient’s question of whether to discontinue her SSRI during pregnancy is one that patients and their providers face daily. There are a number of resources available to guide decision making. When approaching clinical decision making regarding both over-the-counter and prescription medications in pregnancy and lactation, a dedicated discussion about the safety of medications in the context of the disease being treated is optimal. These discussions ideally consider the impact of untreated disease on pregnancy, as well as the possible limitations of the available data for many medications. Patients using newer medications with little safety data, medications associated with known risk, or combinations of medications may benefit from maternal–fetal medicine consultation or referral for genetic counseling to explore the complex risk–benefit profile and arrive at a recommendation for an individual patient.