Background: It is known that women with unintended pregnancies (UPs) experience many challenges. Women with psychiatric vulnerability may face specific concerns regarding the transmission of psychiatric vulnerability, parenting skills and bonding capacities with their offspring. This study aimed to explore how women with psychiatric vulnerability experience UPs. Methods: This is a prospective qualitative study using semi-structured interviews during pregnancy and after delivery regarding the experiences of women with UPs and psychiatric vulnerability and involved partners. Follow-up interviews were conducted three to six months after delivery. Interpretative phenomenological analysis was employed to analyze the data. Results: Women with psychiatric vulnerabilities described unintended pregnancies as complex events, often marked by ambivalent pregnancy intentions, concerns about generational trauma, and fears about parental adequacy. The pregnancies triggered heightened psychiatric symptoms, resurfacing childhood memories, and concerns about stigma, yet also motivated participants to seek support from mental health professionals and trusted others. Women adopted coping strategies such as focusing on the future, seeking distraction, and accepting support to manage emotional challenges. Across pregnancy and postpartum, many participants reported developing strong prenatal and postnatal bonding with the newborn, creating safety nets, and making intentional behavioral changes to support their babies. For several women, the unintended pregnancy ultimately fostered personal growth and contributed to an improvement in mental well-being. Conclusions: This study elucidates the experiences of unintended pregnancies in women with psychiatric vulnerability. Our findings show that for women with psychiatric vulnerability, UPs may also become a window of opportunity for treatment, personal growth and create a safety net for the baby and oneself. This work may help mental healthcare providers to support comprehensively expectant parents who decide to continue UPs.

The codetree represents the hierarchical thematic structure derived from the qualitative analysis and visualises the analytic process through which meaning was constructed across interviews. Four overarching themes were identified: (1) Ascribing meaning to an unintended pregnancy, (2) Impact on mental health, (3) Coping, and (4) Transition to parenthood.

The first theme captures participants’ processes of sense-making regarding unintended pregnancy, including conception by misconception, uncertainty about intentions, decisional ambivalence, and reflections on reproductive agency. The second theme addresses the psychological consequences of unintended pregnancy and is structured around subthemes such as mixed symptomatology, perceived stigma, and the need for a safety net. The third theme, Coping, reflects adaptive and maladaptive strategies through subthemes including taking one step at a time, breaking old patterns, and seeking pillars of support. The fourth theme, Transition to parenthood, encompasses experiential changes across the perinatal period, including reality kicking in, transition to motherhood, personal growth, and the father’s perspective. Together, these themes depict a dynamic process in which unintended pregnancy is negotiated within the broader context of mental health, social environments, and evolving parental identities.

The semi-structured interview script was designed to explore the lived experiences of individuals and their partners in the context of unintended pregnancy and mental health across the antepartum and postpartum periods. The guide is organised around a grand-tour question followed by thematically clustered prompts addressing reproductive intentions, psychological vulnerabilities, social and cultural context, perceived stigma, intergenerational issues, and expectations regarding parenthood. Antepartum interviews focus on meaning-making of pregnancy, environmental and relational influences, psychiatric history, and anticipations of motherhood, while postpartum interviews revisit these topics in relation to actual parenting experiences, mother–child bonding, and desired forms of support. A separate partner interview mirrors this structure to capture the paternal perspective and the relational dynamics surrounding the transition to parenthood. This structure ensured both consistency across interviews and sufficient flexibility to elicit rich, in-depth narratives.

This document provides a structured overview of the recruitment procedures and the inclusion and exclusion criteria applied in the study. It details the recruitment setting and timeframe, participant and partner invitation processes, sampling strategies, interview schedule, and the eligibility requirements for both pregnant women and their partners.