Experiences with family planning amongst persons with mental health problems 61 Domain 3: Parenting In total, 151 respondents (4 close ones and 147 (former) patients had children or reported for a person with children (in the case of close ones)). Figure 3.3 displays views on the influence of mental health on parenting and early parenthood. Supplementary Table S3.3 provides all raw data supporting Figure 3.3. One-third of 3% of (former) patients expressed that their mental health situation was related to all aspects of parenthood. Approximately half of them felt supported by their partners during parenthood and when mental health impacted the lives of their children (46.9% and 49.0%, respectively). Close ones in our sample responded differently: questions regarding the impact of mental health problems during pregnancy and in the first years of parenthood, in addition to feeling impaired as a parent, were answered with ‘yes’ by close ones to a lesser extent (respectively, 0.0% and 25.0%). Partner support was present according to 75.0% of close ones in our sample, and support when mental health problems impaired the lives of children was present according to all responding close ones 100% of the time. In free-form text boxes, (former) patients explained that a history of mental health problems also aided in their parenting. The ability to understand their child’s needs as they often resembled their own needs, the ability to reflect on one’s own actions because of trained self-reflection in therapy, and the ability to ask for help in a timely manner were mentioned as positive aspects of (a history of) mental health problems. Domain 4: Sexuality Figure 3.4 presents results for sexuality and contraceptive use. Supplementary Table S3.4 provides all raw data supporting Figure 3.4. Most of the (former) patients experienced a taboo in discussing sexuality (in general), which was not reflected in the close ones’ view. In free-form text boxes, (former) patients explained that conversation about sexuality was not permitted in previous generations, in addition to experiences of abuse (in the nuclear family) and feelings of shame. Respondents also mentioned that mental health problems caused by (physical) trauma interfered with sexuality. Moreover, (former) patients explained that not being able to talk about sexuality worsened sexual problems, and both (former) patients and close ones agreed on mental health problems negatively influencing sexual enjoyment. Contraceptive use when at risk for pregnancy (i.e., being sexually active without intention to become pregnant) was the norm (83.3%) according to the close ones and (former) patients (75.3%). Reasons reported by (former) patients and close ones for not using contraceptive methods were: being in a same-sex relationship, having an involuntary sexual relationship, being convinced of one’s infertility due to long periods of amenorrhea, having an infertile partner, being convinced by a partner to not use
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