Family planning decision-making in relation to psychiatric disorders in women: a qualitative focus group study.

IF 3.6 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Reproductive Health Pub Date : 2024-07-02 DOI:10.1186/s12978-024-01836-8
Shahenda A I H Ahmad, Jorina Holtrop, Monique J M van den Eijnden, Nini H Jonkman, Maria G van Pampus, Odile A van den Heuvel, Birit F P Broekman, Noralie N Schonewille
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Abstract

Background: Recent studies revealed an elevated likelihood of unintended pregnancies among women with psychiatric disorders compared to their counterparts without such vulnerability. Despite the importance of understanding family planning decision-making in this group, qualitative inquiries are lacking. This study explored family planning decisions among women with psychiatric disorders.

Methods: Utilizing a qualitative approach, three focus group discussions were conducted with purposive sampling: women with a history of unintended pregnancies (N = 3), women without children (N = 5), and women with a history of intended pregnancies (N = 9), all of whom had self-reported psychiatric disorders. Using thematic framework analysis, we investigated the themes "Shadow of the past," reflecting past experiences, and "Shadow of the future," reflecting future imaginaries, building upon the existing "Narrative Framework."

Results: The Narrative Framework formed the foundation for understanding family planning among women with psychiatric disorders. The retrospective dimension of focus group discussions provided opportunities for reflective narratives on sensitive topics, revealing emotions of regret, grief and relief. Childhood trauma, adverse events, and inadequate parenting enriched the "Shadow of the past". The "Shadow of the present" was identified as a novel theme, addressing awareness of psychiatric disorders and emotions toward psychiatric stability. Social influences, stigma, and concerns about transmitting psychiatric disorders shaped future imaginaries in the shadow of the future.

Conclusions: This study enlightens how family planning decision-making in women with psychiatric disorders might be complex, as marked by the enduring impact of past experiences and societal influences in this sample. These nuanced insights underscore the necessity for tailored support for women with psychiatric disorders.

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与妇女精神障碍有关的计划生育决策:焦点小组定性研究。
背景:最近的研究表明,与没有精神障碍的女性相比,患有精神障碍的女性意外怀孕的可能性更高。尽管了解这一群体的计划生育决策非常重要,但却缺乏定性调查。本研究探讨了精神障碍妇女的计划生育决策:采用定性方法,有目的性地进行了三次焦点小组讨论:有意外怀孕史的女性(N = 3)、无子女的女性(N = 5)和有计划怀孕史的女性(N = 9),她们都自称患有精神障碍。利用主题框架分析法,我们以现有的 "叙事框架 "为基础,研究了反映过去经历的主题 "过去的阴影 "和反映未来想象的主题 "未来的阴影":叙事框架 "为理解精神失常妇女的计划生育奠定了基础。焦点小组讨论的回顾维度为敏感话题的反思性叙述提供了机会,揭示了遗憾、悲伤和释然的情绪。童年的创伤、不良事件和养育不当丰富了 "过去的阴影"。现在的阴影 "是一个新颖的主题,涉及对精神障碍的认识和对精神稳定的情绪。社会影响、耻辱感以及对精神疾病传染的担忧塑造了 "未来阴影 "中对未来的想象:本研究揭示了患有精神障碍的女性在做出计划生育决策时的复杂性,过去的经历和社会影响对这一样本产生了持久的影响。这些细致入微的见解强调了为患有精神障碍的妇女提供量身定制的支持的必要性。
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来源期刊
Reproductive Health
Reproductive Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.00
自引率
5.90%
发文量
220
审稿时长
>12 weeks
期刊介绍: Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access. Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.
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