To mark World Autism Awareness Day, April’s Search Pack of the Month brings together a broad collection of maternity research on autism, from pre and postnatal risk factors to the lived experiences of autistic mothers in maternity services.
Autism, or autism spectrum disorder, covers a wide range of neurodevelopmental differences. Each autistic individual has their own strengths, needs and preferences, which can evolve over time. Autism spectrum disorders are characterised by varying degrees of difficulty with social interaction and communication, atypical patterns of behaviour and focus, and unique reactions to sensation. Although some traits can appear in early childhood, many people – particularly women- remain undiagnosed until adulthood, and some may never get diagnosed.
April 2 is World Autism Awareness Day (WAAD), as established by the United Nations in 2007. It is an annual reminder of the importance of inclusion across all areas of society, and a time to promote awareness and understanding of the strengths and challenges that autistic people face. The World Health Organization estimated in 2021 that autistic individuals make up approximately 1 in every 127 people worldwide, making autism-informed approaches essential on individual and societal levels, and vital in maternity care.
For maternity care professionals, research on the topic of autism is broadly split into two strands; screening and risk factors for autistic infants, and experiences of autistic mothers.
Autism and infants
A significant portion of April’s Search Pack contains research on prenatal risk factors and screening for autism. In recent years there has been a flurry of media attention debating whether prenatal factors can increase the chance of autism in babies. It is important to always refer to the evidence before offering advice to women, and our Search Pack has a wealth of information backed by research to help maternity care professionals give accurate and current advice. This includes research on topics such as the impact of paracetamol, maternal preeclampsia, and childhood vaccines on instances of autism.
Caring for autistic mothers
The second major theme in the Pack focuses on the experiences of autistic mothers in maternity services, and the ways in which practice can become more inclusive. Research has found that autistic women face several barriers in maternity care:
- Autistic women report experiencing communication barriers and misunderstanding in appointments, labour and the postnatal period.
- Environmental factors include strong lighting, noise or smells can create significant discomfort for autistic people.
- Frequent staff changes disrupt routine and make the maternity care environment feel particularly unpredictable.
These factors can all contribute to heightened anxiety and distress for mothers. Since many autistic women are undiagnosed or may not wish to disclose their diagnosis, upholding sensitivity, flexibility and woman-centred care throughout pregnancy, birth and the postnatal period is beneficial for all women. Maternity care professionals can make their care more inclusive by:
- Using direct and unambiguous communication.
- Allowing extra time for the mother to process information and ask questions.
- Recognising that many autistic individuals – particularly women – have learnt to mask their autism, which can lead to them hiding pain, anxiety or stress.
- Reducing sensory overload where possible, including dimming lights and reducing noise.
- Explaining all procedures in detail and always seeking consent before touching.
- Adopting the continuity of care model to increase predictability and routine.
Additionally, Tommy’s charity have an advice page for autistic individuals who are pregnant or planning to be pregnant. The advice covers everything from planning for pregnancy, through midwife appointments, coping with pregnancy symptoms and writing a birth plan, plus the postnatal support available to mothers. This may be a resource you want to signpost mothers to at their first midwife appointments. You can find it linked below.
Our free Search Pack for April – PN156: Autism – gathers decades of research on autism in maternity care to support maternity professionals in providing inclusive, informed and evidence-based care. Access the free resource at the link below.
What are MIDIRS Search Packs?
Our Search Packs are pre-made literature searches on topics within maternity research. They contain a comprehensive bibliographic list of articles as well as article abstracts. MIDIRS subscribers can find all of our Search Packs on the MIC database by searching for the specific number of a Search Pack. You can find a list of all of our Search Packs (and their corresponding numbers) here. If you require a more specific search, our librarians are also on hand to provide bespoke literature searches. You can order a bespoke search on our Products and Services page.
Take a look back at articles on the topic of autism that have featured in past editions of MIDIRS Midwifery Digest:
‘Supporting women with autism during pregnancy, birth and beyond.’ Lesley Turner (December 2017)
Women with a diagnosis of autism are accessing maternity care and practitioners have often received little education or training in this area. This article explains some of the qualities associated with autism and how these can affect a woman’s experience of pregnancy, birth and parenting. The areas of communication, sensory perception, emotional regulation and cognition are explored. Reasonable adjustments are suggested based on the published evidence.
Further research is needed to inform evidence-based practice. We must invest in the training of maternity staff so that women with autism are not disadvantaged due to their condition and the care they receive.
‘An extended literature review into the perinatal experience of autistic women.’ Rachel Cadden, David Charnock (March 2025)
Background: Autism is a form of neurodivergence that is under-researched and under-diagnosed in women. Poor mental health is more common in autistic people. The perinatal period is a high-risk life stage for women’s mental health, with previous mental health problems a particular risk factor. Limited research into autistic women’s experience of the perinatal period exists to date.
Aim: An extended literature review in order to better understand how the perinatal period is experienced by autistic women.
Method: CINAHL, EMBASE and PubMed databases were searched from 2014 to 30 June 2024, for qualitative research about the perinatal experiences of autistic women. The quality of the included studies was appraised using the Holland & Rees framework (Holland & Rees 2010) for critiquing qualitative research and the Feminist Quality Appraisal Tool (Morgan et al 2016). The findings were thematically analysed.
Findings: Ten papers were found using the search strategy and were included in the thematic analysis. Three themes were found: communication challenges with health care professionals; a common experience of strong mother-child bond; and heightened sensory experiences. All the included studies were of good to very good quality; however, all lacked diversity.
Conclusion: The impact of midwives – and healthcare professionals – more broadly, on the communication and sensory experiences of autistic women during the perinatal period is clear. Within the discussion, we delve into how education and training could tackle this. We also explore one of the common findings – that autistic mothers are good mothers The prevalence of positive stories of autistic motherhood in the findings provides fuel to weaken prejudiced ideas about autistic mothers.
‘Tailoring intrapartum care for childbearing individuals with autism spectrum disorder.’ Bethan Mooney (March 2026)
This article aims to highlight the urgent need for individualised, autism-informed intrapartum care. While individuals with autism spectrum disorder (ASD) are often referred to perinatal mental health services, it is important to recognise that ASD is not a mental health condition. As such, standardised mental health
pathways may not address their specific needs. Without appropriate, tailored support, the intrapartum period can become a source of trauma rather than empowerment. My focus on intrapartum care stems from a noticeable gap in the literature and practice guidance in this area.
This article hopes to inspire individualised care that promotes inclusive, person-centred and sensory-friendly care for ASD childbearing individuals throughout the intrapartum period, through using the Inclusive London (2025) ‘social model of disability’ approach. The social model of disability focuses on how barriers in society and health care create disability, rather than viewing individuals as able. For example, a person who needs a wheelchair is only disabled when they do not have access to one. It is society’s obstacles, not the individual, that cause disability. The same can be applied to ASD child bearers and, with the right adaptation to care, we can minimise the risks and provide positive tailored care to our ASD patents (Inclusive London 2025).
To read these papers in full, plus hundreds more midwifery-related articles, subscribe to MIDIRS and access our full MIC database, as well as our quarterly Digest.
