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Neurodiversity and Maternity

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What is neurodiversity and neurodivergence?

‘Neurodiversity’ is the term used for the different ways a person’s brain makes them think, feel and behave.

‘Neurodivergence’ is the term used when someone’s brain processes information and events that make them think, feel or behave differently from what society considers to be ‘typical’.

Some of the conditions that are most common among those who describe themselves as ‘neurodivergent’ are:
Attention deficit hyperactivity disorder (ADHD)
Learning disabilities (LD)
Autism spectrum disorder (ASD)
Dyslexia
Dyspraxia
Dyscalculia
Being neurodivergent often presents challenges in a world where society is mostly neurotypical.
For example, support may be needed to apply cognitive skills to a particular task such as learning to read, calculating mathematical equations or regulating emotions.
About 15% of the population are neurodivergent. Women are often not diagnosed until later in life. This can be because girls are more likely to develop strategies to help them cope and blend in, especially in social situations. This is called ‘masking.

However, conditions such as autism and ADHD present differently in girls, and the symptoms can often be much more subtle and easier to miss.

Those who are neurodivergent can also experience anxiety, depression, obsessive-compulsive disorder (OCD), eating disorders, chronic pain conditions, polycystic ovary syndrome (PCOS), Ehlers Danlos syndrome, and postural tachycardia syndrome (POTS).

Being pregnant and neurodivergent

Pregnancy can be an exciting time, but also a challenging one. It is important to tell your doctor as soon as you know you are pregnant. Your doctor and midwife will make sure you get the right care and support..
Let a Midwife Know You're Pregnant - Suffolk and North East Essex Maternity and Neonatal Services
Neurodivergent people can experience greater sensory responses and increased anxiety and communication difficulties. You may worry how pregnancy will influence these.

At your first antenatal appointment with a midwife, you can discuss any extra support you will require. For example, your midwife can:

  • write things down to help you remember the discussion
  • invite you to appointments at quieter times
  • allow for longer appointments so you can ask questions
  • make sure there is a quiet place with not too much noise
  • send communications to you via text messages

Being pregnant and neurodivergent

At your first antenatal appointment with a midwife, you can discuss any extra support you will require.

For example, your midwife can:

01. Allow for longer appointments so you can ask questions

02. Make sure there is a quiet place with not too much noise

03. Send communications to you via text messages

04. Invite you to appointments at quieter times

05. Record the appointment to listen back later

Maternity services are able to make small changes called ‘reasonable adjustments’ which could really help you if you are neurodivergent.

Talk to your midwife about what is possible.

Download First antenatal appointment ask your midwife infographic as PDF
You can also record the appointment to listen back to later, if that helps.

Your midwife can help you to use a Personalised Care and Support Plan (PCSP) which will tell maternity staff how to support you through your pregnancy, birth and after the birth. You may find this useful as you can write down your questions for each appointment.

Hear Alexis talking about birth plans.

You can download your own PCSP

It may be helpful to know when you can expect to see your midwife or doctor.

Timeline for antenatal appointments

Maternity services are able to make small changes called ‘reasonable adjustments’ which could really help you if you are neurodivergent. Examples of reasonable adjustments might include:

  • Clear and simple explanations of what’s happening
  • Help with appointments
  • Scheduling appointments at less noisy/busy times
  • Providing information in many ways that work for you

Talk to your midwife about what is possible.

 

Communicating with staff

Karen Henry who explains what some of the words and pregnancy-related medical terms mean.
Cathy Jackson is an autistic parent. She talks about communicating with midwives and offers some helpful tips.

Hormones & neurodiversity

Research tells us that female hormones change during the menstrual cycle, pregnancy, and menopause, and that this can significantly affect the mental health of neurodivergent people. Changing levels of oestrogen can affect some ADHD medications, making them less effective.
When you become pregnant you will experience changing hormones and some people have reported pregnancy to have a positive effect on their ADHD symptoms.
After you have given birth, oestrogen levels decline rapidly. This can cause adverse symptoms leading to an increased chance of developing postnatal depression, OCD, intrusive thoughts, and postpartum psychosis.
Research highlights that neurodivergent women are at a greater risk of developing these conditions after pregnancy, 61% of people surveyed reported symptoms of postnatal depression which lasted up to a year.

Maternity services have specialist perinatal mental health midwives and can signpost you to emotional support if you need it.

You can find more information on our Emotional Wellbeing webpage.
Hear midwife Laura Spence discuss hormones and ADHD.

ADHD Medications in Pregnancy

If you take medication for your ADHD, your doctor may advise you to stop taking it or change to another type. This is because we don’t fully understand how ADHD medication could affect a developing baby.

Do not stop taking your ADHD medication before talking to your doctor. This can make your symptoms return or get worse.

Whilst some people can manage their ADHD symptoms without medication, for many, their ADHD symptoms impact their daily lives considerably. Stopping your medication without your doctor’s support can have a significant impact on your symptoms and mental health. It is always advisable to book an appointment with your GP to discuss your medication as soon as you know you are pregnant.

If you take ADHD medication in the last few weeks of pregnancy, your baby will be closely monitored for a few days after the birth. This is because there’s a risk your baby could be dependent on the medication, so their body needs time to get used to being without it.

Preparing for the birth

If your pregnancy has been straightforward and uncomplicated you might consider giving birth at home, if that would make you feel most comfortable. You can discuss this option with your midwife.
Find out more about home births.

We recommend you think about what you will need to pack for yourself and your baby a few weeks before your baby is due and it’s a good idea to pack your bag early.
You might want to include:

  • Noise reduction headphones
  • Weighted blanket
  • Fidget/comfort items
  • Familiar items from home and familiar smells

Packing your hospital bag

We recommend you think about what you will need to pack for yourself and your baby a few weeks before your baby is due and it’s a good idea to pack your bag early.

Packing your birth bag and some sensory items to consider

Noise reduction headphones

Weighted blanket

Fidget/comfort items

Familiar items from home and familiar smells

Download Packing your hospital bag infographic as PDF

What to expect in labour

It may be possible to visit the birth rooms in pregnancy to familiarise yourself with them. Ask your midwife about this. Some maternity units offer a virtual tour of the birth rooms:

Colchester

Colchester Hospital midwifery-led unit (Juno) access guide
Colchester Hospital obstetric-led unit (Delivery Suite) access guide

Ipswich

Ipswich Hospital, Brook Ward access guide
Ipswich Hospital obstetric-led unit (Deben) access guide

West Suffolk

West Suffolk Hospital Birthing Unit access guide
West Suffolk Hospital Labour Suite access guide

How to improve your birthing environment

You should be aware that some monitoring offered to you involves touch, including listening to your baby’s heartbeat, checking your blood pressure or temperature and taking blood from you if needed. Each time you are offered monitoring, you can expect a conversation and an explanation on the procedure with the midwife. You can choose to accept or decline the procedure.

Sensory Adjustments

Make it less bright

Try dimming the light and using LED candles or fairy lights

Reduce the noise

Ask care providers to talk quietly, and perhaps turn down volume on monitors

Relaxing images

Bring a picture from home that makes you feel relaxed or at peace

Home smells and comfort

Bring your own pillow/blanket that smells like home

You might want to think about what will help you get comfortable in the birth room. Being upright and mobile will make labour quicker.

You can ask for:

  • A birth ball (exercise ball)
  • A birth stool
  • Floor mats
  • Bean bags/extra pillows

You can also ask to use the birth pool or bath.

Download Sensory adjustments infographic as PDF

You may want to think about how small changes can improve your experience. These are called sensory adjustments:

  • Dimming lights
  • Reducing noises (such as turning down the volume on the monitor)
  • Bringing in a relaxing picture from home
  • Bringing in your own pillow/pillowcase

You might want to think about what will help you get comfortable in the birth room. Being upright and mobile will make labour quicker. You can ask for:

  • A birth ball (exercise ball)
  • A birth stool
  • Floor mats
  • Bean bags/extra pillows

You can also ask to use the birth pool or bath.

The sensory experience of giving birth explains how you can help yourself in labour.

This film explains how a good sensory experience can improve your labour.
You can see here how different positions in labour might work for you.
While you are in labour a midwife will care for you and your baby. Depending on the time of the day and how long your labour lasts you may find that you see more than one midwife. If a new midwife takes over your care they will get to know you and your supporter and read your birth plan carefully.
If you or your baby need extra support in labour there may be more staff in the room. This might include a doctor, an anaesthetist or a neonatologist (baby doctor). Everyone will be introduced to you and will explain why they are there.
Who you might meet
Sometimes in labour you may need to change rooms if you need extra support from doctors. Sarah is an autistic parent and in this video she talks about her experience of moving locations in hospital.

After your baby is born

First hour after birth

The first hour after the birth you will be encouraged to hold your baby close. This helps with bonding.
For some neurodivergent people this can be daunting and they may not feel an instant connection or want to hold their baby straight away. You may feel overwhelmed during this time.
You and your baby may need some extra care too which can involve further examinations, observations and possible blood tests. All of these would be offered to you with an explanation and you will have time to discuss and consider your choices.

The Postnatal ward

A few hours after birth, you will usually go to the postnatal ward before going home. You may be in a room with other women and babies, however, you can request a private room if there is one available and a designated person to stay with you for support. You will be offered the newborn examination for your baby where a midwife will check baby over and maternity staff will offer care and support during the first few hours/days of becoming a new parent.

At home with your baby

When you are home with your new baby you can expect a visit from a midwife or maternity support worker on days 1, 3 and 5 to offer support and make sure you and your baby are well. Further visits can be requested if you feel they would benefit you. On day 5 you will be offered a screening test for your baby. Find out more about the screening test.

Feeding your baby

You may choose to breast feed or bottle feed your baby. Some people experience sensitivities around breast feeding; however, the choice is yours. Your midwife can talk you through each method before your baby arrives. Link to feeding film here

Ruth is an autistic parent and talks about feeding your baby in this video.

Partners/dads and ADHD

Becoming a parent, especially if you identify as an autistic parent can be challenging.

Hear David describe his experience.

Jacob Kelly describes the experiences of neurodivergent partners and dads.

Will my baby be autistic or have ADHD?

Whilst research indicates that neurodivergence is passed on genetically, this does not mean that your baby will be neurodivergent. If you have any concerns regarding your baby’s development and communication during their early years, you can speak to your health visitor who can offer support and make a referral if required.

Where to find support

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