I believe I was on a 20 mg. dose for about the first eight weeks of my pregnancy. My son was born with a malformed fourth ventricle in his brain, which led to a slow and steady build-up of cerebral fluid in his skull over the course of the years. He was diagnosed last December with an arachnoid cyst (i.e., big pocket of fluid) that was displacing a large portion of his brain and required surgery in January (the day before his fifth birthday) to fenestrate the ventricle and alleviate the pressure. We are having testing done for cognitive and motor impairment this week.
I do not tell you this to scare you! He may be fine, although we are seeking professional help for some issues that he is having. However, the only reason I stopped taking the Paxil when I was pregnant with him was because my pharmacist said there was not enough data to say whether or not Paxil is safe during pregnancy. I thank God that I had the presence of mind to ask.
I have read that fetal cardio-vascular issues (the fourth ventricle is part of the vascular system) may result from taking Paxil in the first trimester. I can't help but wonder if that wasn't at least part of the problem for my son. We know the cyst was congenital, and that it developed very slowly over the course of the last five years - and probably throughout gestation. Arachnoid cysts are not genetic or hereditary, meaning this is not likely to have been a condition he inherited from me or my husband.
So, by all means, do talk to your doctor! There may be better alternatives for pregnant women, or your doctor may think your low dose is fine.
Hope this helps.