Family planning decision-making in relation to psychiatric disorders in women 133 Emotions toward psychiatric stability Psychiatric stability at the time of decision-making was mentioned as one of the factors influencing choices. For some individuals, the stability of symptoms presented an opportunity to pursue parenthood, while for others, psychiatric stability did not hold the same level of deliberative weight. Diverse attitudes toward this issue highlight how some participants experienced resilience by learning from previous experiences, while others did not. Perceptions of desire for children A spectrum of diverse viewpoints on the desire for children was described as a complex array of thoughts, emotions, and perspectives that concurrently coexist, contributing to a fluctuating experience over time and giving rise to feelings of ambivalence and uncertainty. As one participant expressed “childbearing desire is not 100% yes or 100% no,” highlighting nuanced attitudes toward motherhood and childlessness. While ‘perceptions’ were originally emphasized as personal interpretations of past and current experiences29 our participants argued that viewpoints on the desire for children change over time. Status Opportunities and constraints for childbearing plans resemble the (socioeconomic) status element of the Narrative Framework29. This category includes several factors mentioned as reasons whether to have a child, including maternal age, financial stability or having a (stable) partner. Shadow of the future The shadow of the future emphasizes the importance of expectations and personal narratives in uncertain situations29. Our study shows how social influences, stigma around mental health, and uncertainty about passing on a condition can influence future imaginaries (Table 6.7). Social influences During the focus group discussions, the social system’s impact was heavily discussed. Many expressed frustrations with the lack of support from their social environment for their desire for children, leading to uncertainty about their decision. While personal visions of the future can be influenced by society, personal visions may also differ, thereby placing social influences in the shadow of the future29. Participants’
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