Fertility decision-making after an experience of first-onset postpartum psychosis

Fertility decision-making has consistently emerged as a key aspect of longer-term recovery for women who have experienced postpartum psychosis (PP). However, there remains a paucity of research regarding an in-depth exploration of the experience of fertility decision-making after first-onset PP. Women who have experienced first-onset PP have no prior history of mental health difficulties but have a significantly higher risk of recurrent PP in subsequent postpartum periods. The study aimed to explore women's experiences of fertility decision-making, including the meaning of decisions and experience of support, after an experience of first-onset PP.

Nine women were recruited through purposive sampling. Qualitative data was gathered via semi-structured interviews and analysed using Interpretative Phenomenological Analysis (IPA).

Six Group Experiential Themes (GETs), associated with twelve subthemes, were identified: Decision-making as 'a bit of a process', Fear of recurrence, Desire to have more children, Grief, Support needs, and Accepting the decision.

Findings represented the complex, emotional, and deeply personal process of fertility decision-making, shaped by the experience of first-onset PP. Future research and clinical implications, such as the need for specialist, psychologically informed preconception support, are discussed.