Chapter 9 254 Support in exploring one’s own ideations about possible parenthood can be found with peers. We issued a booklet with lived experiences from people with psychiatric vulnerability about family planning decision-making, pregnancy journeys, parenting and sexuality (https://mindplatform.nl/projecten/kinderwens-en-ouderschap). Contact with others who experienced childhood trauma provided support in pregnancy journeys (Chapter 7). For both expectant mothers and fathers, unexpected pregnancies give rise to questions and uncertainties. Stories from those with lived experience could provide support (Chapter 7, https://mindplatform.nl/projecten/ kinderwens-en-ouderschap). The presence of a significant other during conversations about family planning was wanted by persons with psychiatric vulnerability (Chapter 3). The discussion tool (Figure 9.5) could facilitate a conversation about family planning with a person with psychiatric vulnerability and can help to overcome barriers. Women with UPs and their partners can be supported by understanding the different stages of mental health impact during pregnancy and the postpartum (Chapter 7). Uncertainties regarding mother infant bonding were raised by pregnant women with psychiatric vulnerability (with and without UPs) (Chapter 3,6,7,8). Thus we advise to offer women with psychiatric vulnerability a referral to facilities that offer attachment based interventions like Infant Mental Health organizations74. In addition, maternal role training75 has proven beneficial in preparation for motherhood. We are unaware of support groups for women with UPs who choose to continue their pregnancies. However, positive psychological interventions may positively impact antenatal mental health and pregnancy acceptance76. We suggest that, while specific precautions concerning lithium use may be extensive, it is advisable to implement combined observation of mothers with bipolar vulnerability and their infants in a nursery setting (level 1 care) to enhance mother-infant attachment (Chapter 5). As ultrasounds aided in pregnancy acceptance and attachment to the (unborn) child, women who choose to maintain their UPs could benefit from seeing the fetus on ultrasounds (Chapter 7). Finally, there is an urgency for society to change its attitude towards pregnancies that are not greeted with happiness, as pregnancies can be experienced very differently by persons and the acceptance of the pregnancy can change over time (Chapter 7). The stigma that is related to parenting in persons with psychiatric vulnerability could be diminished by discussing reproductive health matters openly and without judgement for all individuals (Chapter 6, Chapter 8). There are examples of promising stigma reducing programs regarding abortion and reproductive health77. In their report on the neglected crisis of UPs, the United Nations vouch for comprehensive sexuality education, which entails ‘’a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality, aiming to equip children and young people with knowledge, skills, attitudes and values that will empower them to realize their health, well-being
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