Exploring UP journeys among women with psychiatric vulnerability using interpretative phenomenological analysis 185 Implications for future research To date, many studies have focused on the adverse outcomes of pregnancies in women with psychiatric vulnerabilities, and potentially positive effects may have been overlooked9-11,53. Future studies may investigate the positive effects of UPs and possibilities for relational growth, personal growth and improvement of mental health. Moreover, further qualitative research might explore the perceptions of women with mental health problems regarding pregnancy planning and UPs in different subgroups (such as single parents and women who consider abortions) and geographical regions. The current clinical interventions available for this subgroup of women with psychiatric vulnerability in relation to UPs are limited. However, a deeper understanding of women’s needs could help policy makers develop tailored interventions to improve pregnancy decision making and, if desired, pregnancy acceptance and maternal-infant bonding45,54,55. For example, our findings suggest that ultrasounds may help these women increase awareness of being pregnant and increase bonding with the child during pregnancy. A scoping review on the transition to motherhood previously issued a warning that it would be a waste not to utilize the potential for growth during the transition to motherhood, a period in which existential questions are raised for expectant mothers56. Indeed, welcomed pregnancies could provide a window of opportunity to obtain appropriate psychiatric healthcare, tackle transgenerational patterns and assist in decreasing the impact of hereditary psychiatric disorders and trauma by improving the preconception and antenatal health of mothers. This will help to build healthy future generations. Conclusions This research reveals novel perspectives on how women with psychiatric vulnerability experience unintended ongoing pregnancies. Through a phenomenological lens, we delineated how UPs impacted pregnancy journeys in our sample and triggered reflections on childhood experiences. UP journeys differed among women with psychiatric vulnerability, and the decision to carry the pregnancy was made in a personal way. Despite the perception of UPs as challenging pregnancies, as also seen in other samples, for women with psychiatric vulnerability, UPs may help to create a momentum to engage in mental health treatment and might offer the potential for personal growth. The narratives from our work provide further understanding of women’s experiences among MHPs and may help them to comprehensively support expectant parents with psychiatric vulnerabilities. Finally, society challenges pregnant women with psychiatric vulnerability and UPs by imposing stigma and expectations. MHPs could help decrease the pressure and stigma that impacts UPs by openly and
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