The physician managing major depression during pregnancy and lactation must weigh the risks and benefits of treating with antidepressant medication. Investigators examining this question in previous work found that women with major depression during pregnancy were at increased risk for preterm birth and having infants with low birth weight and intrauterine growth restriction (1, 2). Antidepressant use during pregnancy also is associated with adverse outcomes: women treated with a selective serotonin reuptake inhibitor (SSRI) have a two- to threefold greater risk of preterm birth and a higher rate of delivering low-birth-weight infants than do women with no SSRI exposure during pregnancy (3, 4). In a previous study by Wisner et al. (1), preterm birth rates and infant weight, length, and head circumference for women with untreated major depression or SSRI treatment during pregnancy did not differ from those of women with neither major depressive disorder nor SSRI exposure during pregnancy. As Wisner and colleagues note in their article published concurrently with this editorial (5), much of the other investigative work in this area is limited by not having a group of women with untreated major depressive disorder, a group with SSRI or other antidepressant treatment, and a comparison group without major depressive disorder or SSRI exposure during pregnancy to differentiate the effects of treatment on reproductive outcomes. In addition, many of the previous studies did not examine longer-term effects on infant outcomes. The distinguishing feature of the current study by Wisner et al. is that it examines all three groups of women during pregnancy: those with an untreated depression, those with depression receiving SSRIs, and those with neither major depression or antidepressant treatment during pregnancy. Furthermore, the investigators examined women not only during pregnancy (at 20, 30, and 36 weeks gestation) but also for up to a year postpartum (at 2, 12, 26, and 52 weeks). Other strengths of the study include its prospective design, thorough participant (mother and child) assessments of clinical history, and physical examination by raters blind to condition. Thus, this study sets the gold standard as to how to conduct sound methodological investigations in this field so that clinicians and patients have the necessary information to make informed decisions about reproductive choices.