Supporting Parenting Decisions for Women with SMI

Direct answer

(Mizock et al., 2019) conclude that clinicians can support women with SMI in deciding whether to have children by emphasizing self-determination and by evaluating the resources needed to pursue that goal—rather than treating risk as the only relevant frame.

What to do in practice

1. Ask about parenting goals without assuming desire for children—or the opposite.
2. Center the woman’s values when weighing timing, supports, and alternatives.
3. Map concrete resources: treatment stability, housing, childcare, legal advocacy, peer support, family network.
4. Make room for grief when plans were derailed.
5. Honor reimagined motherhood—caretaking and identity are not limited to one script.

What not to do

• Collapse the conversation to custody loss, violence, or poverty alone.
• Treat SMI as proof that motherhood is impossible.
• Skip documentation of strengths, supports, and the woman’s stated goals.

Source and cluster

Educational summary only—not clinical advice or a substitute for the full paper.

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