Chapter 1 14 mental health professionals (MHPs)64. Even today, there remains a limited number of studies addressing these issues, particularly in countries other than the United States. Qualitative literature involving women with bipolar disorders has demonstrated that family planning is a significant topic of discussion during treatment, with a particular focus on the health of offspring in relation to the use of psychotropic medications and the heritability of bipolar disorder60. Women with borderline personality disorders who recently had a child expressed a desire to prevent intergenerational transmission of attachment problems and borderline personality symptomatology65. In addition, a lack of tailored parenting programs was disclosed. Given that transgenerational transmission of psychiatric symptomatology, parenting in relation to mental health and attachment are topics which generally fall within the expertise of MHPs, we hypothesize that MHPs should play a significant role in facilitating discussions about family planning. Previous studies in the field of reproductive health discussions in psychiatry have revealed that MHPs (and resident MHPs) reported obstacles, including moral concerns regarding patient autonomy and a lack of expertise when addressing family planning66,67. Possibly, patients and their close ones also encounter their own set of challenges in this context. Personal experiences with (the need for) discussing reproductive matters in psychiatry are lacking, both from a MHP and patient perspective. Aims of this thesis My dissertation seeks to provide insight in the impact of unintended pregnancies for individuals with psychiatric vulnerability from various perspectives. We aim to estimate the prevalence of UPs in national and international samples of women with psychiatric vulnerability, collect lived experiences of parents who experienced unintended pregnancies, capture professional experiences of mental health professionals with discussing family planning decision making and gather lived experiences of (former) patients (men and women) and close ones with discussing desire for children in psychiatric healthcare. To reach these goals, this thesis adheres to a mixed methods approach by building upon data from quantitative (parts I and II) and qualitative (part III) research designs. Methodology Table 1.1 presents the applied methods per chapter including data used.
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