Postpartum Psychosis: the Role of Psychosocial Factors and the Experience of Fertility Decision-Making

This thesis portfolio comprises three parts:Part One: Systematic Literature ReviewThe systematic literature review explored the role of psychosocial factors in women’s experiences of postpartum psychosis (PP) using qualitative research. A thematic synthesis of the eight identified papers generated one overarching theme (Misogyny and Motherhood), which connected to six further analytical themes: Perinatal-specific Stress, Trauma and Stressful Life Events, Social Support, Legal Factors, Economic Factors, and Culture, Religion, and Spirituality. Findings demonstrate the extensive role of psychosocial factors across women’s experiences of PP and indicate the need for continued psychosocial engagement in future research and clinical practice.Part Two: Empirical PaperThe empirical paper explored women's experiences of fertility decision-making after an experience of first-onset PP. Qualitative data from semi-structured interviews with nine women were analysed using Interpretative Phenomenological Analysis. Six Group Experiential Themes, 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 represent the complex, emotional, and deeply personal nature of fertility decision-making after first-onset PP and indicate the need for specialist, psychologically-informed preconception support.Part Three comprises the AppendicesThe appendices contain supporting information to the systematic literature review and empirical paper, including reflective and epistemological statements.