Can Exercise Replace Antidepressants During Pregnancy?

Antenatal depression is depression that occurs during pregnancy not after and it affects approximately 1 in 5 expecting mothers. Despite being as common as postpartum depression, it receives far less attention, and that silence has a cost: untreated antenatal depression increases the risk of premature birth, low birth weight, impaired mother-infant bonding, and significantly raises the likelihood of postpartum depression once the baby arrives. For decades, the conversation has offered them exactly two options: take the medication, or push through. That corridor has always been uncomfortably small.The mental health of a mother during pregnancy is not separate from her baby’s development, it is woven into it. For women who do seek treatment, sertraline is the most commonly prescribed option. It belongs to a class of drugs called SSRIs selective serotonin reuptake inhibitors which work by blocking the reabsorption of serotonin in the brain, leaving more of it available between nerve cells. More serotonin in circulation generally means improved mood regulation, reduced anxiety, and better emotional stability.

A 2025 study published in Progress in Neuropsychopharmacology & Biological Psychiatry decided to push back and the results are worth your full attention.

What the Study Did

Researchers put sertraline,  the most commonly prescribed antidepressant in pregnancy, head-to-head with voluntary exercise in a controlled trial. They measured what actually happened in the maternal brain and body. Then they looked at the babies too.

Dr. Nosarieme had a chat with Dr. Noor Jarbou, the study’s lead author and Lecturer at CQUniversity School of Health, Medical and Applied Sciences, to break it all down.

Two Things to Know about Movement

Voluntary exercise during pregnancy can structurally adjust the prefrontal cortex, the brain region responsible for emotional regulation, stress response, and decision-making. Across the lifespan, movement is one of the most potent neuroplasticity triggers we have access to. You are not just burning energy when you exercise you are editing the operating instructions of the brain that runs your mental life. That is available to most people, most days, at no cost.

Sertraline is widely considered safe in pregnancy, in medicine and in everyday health decisions, we often accept “relatively safe” as a reason to stop asking questions. The better habit is to stay curious, ask for the evidence, and understand that informed choice requires the complete story not just the reassuring headline.
next is where it gets remarkable.

The prefrontal cortex, the brain region that governs emotional regulation, stress response, and decision-making — appeared to rewrite its own operating instructions in response to movement. Not masking a symptom. Rebuilding architecture.

The Takeaway

This episode is not anti-medication. Sertraline helps many women, and clinical guidance remains irreplaceable.

But here is what Dr. Jarbou wants you to walk away with:

You are not a passive vessel for chemistry. Movement has real, measurable effects on the maternal brain and those effects are available to you.

For midwives and GPs: the neurobiological evidence for exercise as an antenatal intervention is growing. This study adds a controlled, molecular layer to that picture.

For researchers: the question of how movement rewires the PFC at a cellular level is wide open.

Watch or Listen to the Full Episode

The full conversation goes deeper into the neurobiology, the study design, offspring outcomes, and what clinicians and women should actually do with this information.

🎧 Listen on Spotify / Apple Podcasts: Here
▶️ Watch the full episode on YouTube: HERE

If this opened up a question, a conversation, or a new idea — leave a comment. Share it with someone who needs it.

Until next time – take care of your mind, and stay sane.

Sanity Drive spotlights brain science research and translates it into helpful, accessible insights. New episodes weekly.