Chapter 8 196 with unintended pregnancies, men, women without children and women with intended pregnancies. Nineteen patients responded positively and were assigned to a designated focus group according to whether they had children or not. We included adult patients with lived experience (close ones were not included in the focus groups). This enabled a purposeful sample of motivated participants per group. The desired group size was 2-10 participants as interaction between participants is required in a focus group26. Eventually, a maximum of nine participants agreed to take place in each group. For the survey that investigated the MHPs’ perspective (survey 1), we recruited MHPs at the annual conference of the Dutch Psychiatry Association. The panel survey was distributed in September 2022 amongst the same patient and close ones’ panel from MIND, from which the focus group participants were recruited25. Participants were excluded if age ≤18 years. Data collection Four face-to-face focus groups were held in October and November 2021. The interview guides of each focus group consisted of two main research questions with several sub questions for all focus groups (including one group-specific question that did not relate to conversations about family planning). The main questions were (1) how does your (history of) mental health influences your desire for (more) children? and (2) what is your experience with discussing family planning or desire for children with your MHP? See Table S4 for the interview guides of all four focus groups. For the current paper, we analyzed data available from the second research question. A researcher with lived experience of perinatal mental health problems (ME) led the focus groups. Another researcher (NS) was present to observe and take field notes. The MHP survey was dispersed on May 11th, 12th, and 13th 2022 in Maastricht, the Netherlands. It consisted of 15 questions in Dutch language, with a mix of multiple choice and open questions (see Supplementary file 8.1). In total 2128 MHPs (mostly psychiatrists and residents in psychiatry) attended the conference and were approached in person to participate (online or on paper). The online survey was available up until 14 days after the conference. The panel survey was dispersed in September 2022 and available for 14 days. Panel members were invited through a pre-existent mailing list owned by a MIND employee. The survey consisted of 32 questions in Dutch language (see Supplementary file 8.2). Informed consent was obtained from participants of the focus groups (including a signed confidentiality statement for information shared in the discussions) and both surveys. Focus group participants received a reimbursement for their time investment (40 euros) and travel expenses (maximum of 50 euros). The study was declared as not part of the Human Acts Law and locally approved by the review committee of OLVG hospital and MIND.
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