General introduction and outline of this thesis 15 Table 1.1 - Applied methods per chapter including data used. Chapter Study aim Methodology Data used 2 To explore whether psychiatric vulnerability is a risk factor for UPs, by quantifying the presence of UPs amongst adult women with psychiatric vulnerability, in addition to comparing UPs in women with and without psychiatric vulnerability by means of a systematic literature search and meta-analysis. Systematic review and meta-analysis PubMed, Embase/Ovid, PsycINFO, Cochrane and Web of Science/Clarivate Analytics 3 To elucidate the perspective on family-planning from patients with mental health problems and their close ones. Semi-quantitative patient survey Survey MIND (Box 1.1) 4 To elaborate on previous literature by primarily investigating the incidence of UPs amongst women with various current/past psychiatric diagnoses versus women without psychiatric diagnoses. To compare maternal and neonatal outcomes between women with UPs versus non-UPs who delivered in the hospital and to assess the modifying role of current/past psychiatric diagnoses in the association between pregnancy intention and maternal/neonatal outcomes. Retrospective cohort study MoMentUM study dataset (Box 1.2) https://doi.org/10.1 7026/dans-xrt-du5k 5 To validate previous findings on neonatal outcomes after lithium exposure by comparing (re)admission rates in neonates born to women with BD with versus without lithium exposure. To elucidate the reasons for admissions in neonates born to women with BD. Quantitative retrospective cohort study Lithium dataset 6 To unravel childbearing intentions in relation to psychiatric vulnerability in persons with lived experience. Thematic analysis with framework method Focus groups MIND (Box 1.1) 7 To understand how women with psychiatric vulnerability give meaning to the experience of unintended pregnancies using interpretative phenomenological analysis. Narrative analysis Prospective in-depthInterviews with persons with psychiatric vulnerability during pregnancy and postpartum, included at the OLVG POP clinic in Amsterdam between March 2022 and February 2023 8 To investigate the need and experiences of patients, close ones and MHPs regarding discussing family-planning in mental healthcare during the reproductive phase of life. To inquire what, when and how MHPs should discuss family planning with patients. Mixed methods approach: semiquantitative patient surveys and focus groups Survey MIND, focus groups MIND UPs; unintended pregnancies, BD; bipolar disorders, MHPs; mental health professionals
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