Pregnancy and Parenthood Among Autistic Adults: Implications for Advancing Maternal Health and Parental Well-Being

Abstract

Background: Strikingly little research has considered how autistic adults experience pregnancy and parenthood, two key transition periods in adult development with potentially far-reaching implications for physical and psychosocial health outcomes across the lifespan. This article reviews the research on pregnancy and parenthood among autistic adults, to summarize existing research and identify future directions to advance this critical area of study. Methods: We conducted a systematic review of the literature on pregnancy and parenthood among autistic adults. Researchers extracted selected articles for key information, including methodology and sample size, study location, demographic characteristics of participants, measurement approaches, and key study findings. Results: Overall, we identified 13 studies that used a range of quantitative and qualitative approaches to study pregnancy experiences and outcomes and parenthood among autistic adults. The findings show that autistic adults (1) experience difficulties and dissatisfaction communicating with health care providers throughout pregnancy and birth, (2) are more likely to experience depression during and after pregnancy, and (3) experience higher rates of pregnancy complications, including preterm birth, cesarean delivery, and pre-eclampsia. During parenthood, autistic adults report lower parenting competence, experience parenthood as isolating, have difficulty communicating with professionals about their child and are questioned by providers about their ability to parent, experience high rates of involvement with child protective services, and express a desire for increased parenting support. Autistic adults also reported parenting strengths, including high levels of finding parenthood rewarding and putting their children's needs ahead of their own. Conclusions: A key limitation of the literature is the significant lack of sociodemographic diversity among participants, the small number of existing studies, and reliance on cross-sectional mono-method designs. Future research should be conducted in partnership with autistic adults to develop assessment and intervention approaches for supporting pregnancy health and parental well-being among diverse and underserved communities.

Love, Joy, and a Lens of Childhood Trauma: Exploring Factors That Impact the Mental Health and Well-Being of Autistic Parents via Iterative Phenomenological Analysis

“…49,50 Qualitative studies about autistic parents found that they experienced great joy and intense connections with their children, who were motivators for change and personal growth 21,23,40,51 . In agreement with quantitative studies on this subject 22,33,41,42 , difficulties around communication, judgement and acceptance from professionals were also commonly found.…”

“…3,39 Several studies have found that autistic parents experience difficulties regarding effective communication with professionals (while advocating for their children), and in healthcare settings. 22,32,33,[40][41][42] Autistic people are stereotypically believed to lack empathy, mainly due to Theory of Mind research. 43 More recently, researchers have shown that while autistic people may have some difficulty with cognitive empathy or mentalising (understanding someone else's perspective), they have no differences in affective empathy (feelings of love, compassion, concern, and warmth towards others).…”

Autistic Women’s Experiences of the Perinatal Period: A Systematic Mixed Methods Review

“…Adams and Young, 2021;Raymaker et al, 2017;Maddox et al, 2020;Nicolaidis et al, 2015). It also echoes problems specifically during the perinatal period with attending maternity healthcare highlighted both by McDonnell and DeLucia's (2021) and Grant et al's (2022) reviews. Such barriers to accessing healthcare can lead to adverse outcomes for autistic people (Doherty et al, 2022).…”

“…Samuel et al (2022) identified sensory challenges faced by autistic women during pregnancy and birth. McDonnell and DeLucia (2021) examined experiences and outcomes of pregnancy and experiences of parenthood amongst autistic adults, including both mothers and fathers. Grant et al (2022) used qualitative evidence including both peerreviewed primary research and first-hand accounts found in grey literature to explore autistic women's experiences of infant feeding.…”

‘Living in a world that’s not about us’: The impact of everyday life on the health and wellbeing of autistic women and gender diverse people

“…15,16 Gender diverse autistic people experience higher levels of mental health difficulties compared to both cisgender autistic people 17 and non-autistic gender diverse people, 18 outlining the impacts of being part of multiple marginalized groups on mental health. Autistic women and gender diverse people are also at increased risk of sexual violence 19 and have additional needs related to their health and wellbeing, including sexual and reproductive health, 20 experiences of pregnancy and childbirth, 21 and managing periods and menopause. 22 Despite these additional needs, autistic women and gender diverse people report significantly more barriers to accessing services, 23 including stigma and a lack of knowledge from healthcare providers 24 and are underrepresented in research.…”