Chapter 7 180 did have a bit of a 'oh, crap' feeling. Like, it might just be all exacerbation or recurrence of something, you know, I, and she hasn't had any of that at all. […] What I'm actually trying to say is that it's good that those people [with psychiatric vulnerability] are being followed, you know, and monitored and that there is followup. But I think credit should also really go to those people who seem to be functioning better because of such a pregnancy. So, I'm happy about that and also proud." (Partner of participant 1) Discussion Main findings This study aimed to understand how women with psychiatric vulnerability experience UPs. Four major themes were derived from narratives from nine pregnant women and two partners. The ‘Ascribing meaning to an unintended pregnancy’ theme described how UPs could occur in the context of women’s situations and how a future desire for a family, partner support and having met certain life conditions shaped women’s pregnancy intentions prior to pregnancy, which were often ambiguous. Fear of transgenerational transmission of trauma and psychiatric symptomatology impacted women’s desire for a future family and instilled fear of inadequacy in parenting. The ‘Impact on mental health’ theme illustrated how UPs caused mental health symptoms related to childhood memories, the unexpectedness of the pregnancy and the pregnancy itself. Moreover, women had difficulty announcing their UP due to fear of negative reactions. Prolonged mental health symptoms during pregnancy, in addition to a fear of transmitting childhood traumatic experiences and being an inadequate parent, caused despair. It also caused determination and motivation to seek pillars of support (MHPs, family, friends) during pregnancy. In the ‘Coping’ theme, coping mechanisms such as focusing on the positive or on the future, seeking distraction and allowing support were discussed. The ‘Parenthood’ theme linked imaginations and expectations during pregnancy with postpartum experiences. Fetal movements and imaginations of the baby exemplified women’s feelings toward their unborn child. These feelings were markers of prenatal bonding. In six postpartum narratives, awareness of psychiatric vulnerabilities gave rise to behavioral changes, such as creating safety nets (through access to/awareness of support options), setting boundaries and prioritizing their babies. The narratives illustrated how parent–child bonding could successfully develop after UPs in women with psychiatric vulnerability. For some women, mental health symptoms improved as the UP provided a new purpose in life. This perspective was underscored by two partners. Although UPs are
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