Before, during and after pregnancy for autistic women and birthing people

If you are autistic, tell your GP and midwife so they can support you before, during and after pregnancy.

We know that not everyone agrees on how to talk about autism. For this page we have used the term ‘autistic people’ as this is preferred by most autistic people and their loved ones, according to research. 

On this page

What is autism?

Planning a pregnancy when you’re autistic

During pregnancy

Having your baby

Feeding your baby

Will my baby be autistic?

Where can I get support?

What is autism?

Being autistic means your brain works in a different way to other people. Autism is something you’re born with and it’s a spectrum, so it’s different for everyone.

Like everyone, autistic people each have their own strengths and challenges. However, some autistic people may:

• have differences in the way they communicate and process information. This can make social situations with non-autistic people confusing and tiring.
• be more or less sensitive to things in their environment, such as sounds, smells, touch, light or temperature
• worry about unfamiliar and unexpected situations and social events
• do repeat self-soothing actions (called stimming)
• have focused interests
• find routine and predictability reassuring
• have differences in how they move and co-ordinate their body.

Autistic people may also be more likely to have other conditions, such as epilepsy, anxiety, depression or attention deficit hyperactivity disorder (ADHD). 

Some autistic people need quite a bit of help from a family member, carer, or others in the autistic community, while others need little or no support. The amount of support each person needs can change over time.

Everyone’s experience is different. Something that affects this is other parts of an autistic person’s identity, including their ethnicity and culture. A 2013 report highlighted that people from Black, Asian and Middle Eastern communities may face multiple barriers when getting an autism diagnosis and the right support.

Support is available. Black and Black-Mixed Heritage women and birthing people can contact our specialist Tommy’s helpline for support with any aspect of your pregnancy journey. You can find out more information and book a call here.

Planning a pregnancy when you’re autistic

Being autistic isn’t an illness, but many autistic people also have mental or physical illnesses that may require medication. If you take any kind of medication, keep using contraception until you have spoken to your doctor. They can tell you whether your medication is safe to take in pregnancy. They may advise you to change to a type of medicine that is safer while trying for a baby.

Do not stop taking any medication before talking to your doctor while trying for a baby or at any other time. Doing this can be harmful.

Like anyone, it’s normal for autistic people to have a range of feelings while trying for a baby. It can be an exciting time, but the expectation and disappointment can be difficult to deal with. Some people may find they’re spending a lot of time thinking about things like ovulation tests, timing sex correctly and spotting early pregnancy signs.

If you’re struggling with any of this, try to lean on people you love and trust. Health care experts are also available to give advice. Making an appointment with your GP would be the place to start. You could also look at the website of Fertility Network UK for information about the support they give.

While trying for a baby or after getting a positive pregnancy test, you may want to speak with other autistic parents about their experiences. Getting tips and support from people with shared experiences can be really helpful. 

The National Autistic Society has information for connecting with autistic people who live near to you. Find out more here.

During pregnancy

Finding out that you’re pregnant is a big moment. It’s normal to have lots of feelings and questions, whether your pregnancy was planned or unplanned.

If you are pregnant, tell your doctor as soon as you can. They can advise and support you, and let you know about other support available. If you feel comfortable, you could also tell people you love and trust so they can be there for you.

After you’ve told your doctor or midwifery unit, you will have routine antenatal (before birth) appointments with your midwifery team. If you are worried about these, you may find it helps to tell the midwife that you are autistic and share any of your main needs or concerns. This can help them to help you to get the most from your appointments. 

You can create what the NHS calls a ‘health passport’ and share this with your midwife. It can be as simple or as detailed as you want, and cover things like how you do and do not want to be spoken with and cared for. The NHS has more information on creating a health passport here.

Learn more about health passports and download a template on the National Autistic Society website.

Your appointments

At your first appointment, you can ask if it possible to have one named midwife for your care. This is called 'continuity of care'. It’s not available in all areas but speak to your midwife about your options and for information about how your care and care team will look.

Some examples of things you could ask your midwife are:

• if you can have appointments on a certain day, or at the same time of day each time
• if you can have appointments at home or via a video call. (Most appointments will need to happen in-person as your midwife will need to take your blood pressure and get a urine sample from you.)
• if they can explain in advance what will happen at your appointments 
• if they can provide written notes for you to take home with you 
• if they’re happy with you using a voice memo app to record each appointment, so you can play back what was discussed later. 

You may also find it helpful to take someone with you for support. This could be a partner if you have one or a family member or friend.

If you have concerns or questions at any point during your pregnancy, ask your midwife or doctor. It’s fine if this is outside of scheduled appointments, your midwife or doctor are there to support you. If it helps, write down your questions before you go to your appointment or contact your health care provider. 

The NHS has information on the antenatal appointments you’ll have as standard, including when they are, and what will likely be covered in them. You can use this as a guide for preparing for appointments, and you can also ask your midwife questions in advance too. Read the NHS antenatal appointment page here.

Sensory differences

Processing sensory information can be difficult for autistic people. The five senses (sight, sound, smell, taste and touch) can be over or under-sensitive. When you’re pregnant this can be impacted even more by things like feeling your baby move inside you, and having strong food likes or dislikes related to pregnancy. 

Speak to your health care providers and people you trust for support and advice with this. Speaking with others in the autistic community may be helpful to find out how they deal with sensory challenges.

During pregnancy, labour and birth, there are times when your health care providers will ask to touch you. They should always explain why they’re asking to do this, and get your consent.

Having your baby

Giving birth can be unpredictable. You may want to write a birth plan, but bear in mind that things may not always go completely to plan. Your birth plan can cover where you’d like to give birth (a hospital, a birth centre or at home) and other things like whether you’d like pain relief and if so, what type.

You may want to tell your midwife and note in your birth plan if:

• you have strong sensory likes or dislikes. For example, write down if you’d prefer dim lights and a quiet room when giving birth.
• you don’t experience or communicate pain in the same way as other people. If this is true for you, be sure to let your midwife know. This will help them to take care of you while you’re giving birth.
• you’d like to go on a tour of the hospital or maternity unit, if you’re planning on giving birth there, so you’re familiar with the setting before you go into labour. You can ask to do this earlier on in your pregnancy if you’d find that helpful. Not all hospitals do in-person tours as standard but some offer virtual tours on their websites.

Many new parents worry about whether they will bond with their baby, whether they’re autistic or not. You may bond with your baby straight away or it may take a little time. You can get advice and support from your midwife and health visitor around bonding with your baby.

Feeding your baby

Breastfeeding can be hard for anyone, but some autistic people may find it even harder if they choose to try it. For example, if you’re sensitive to touch, breastfeeding could make you feel overstimulated.

Your midwife will help you start to feed your baby after the birth. Your health visitor can also support you during their visits to you in the weeks after your baby’s birth. They can tell you about breastfeeding support groups near where you live.

Find about more about what a health visitor does here.

Many autistic people can breastfeed with the right support if that’s what they feel is best for them and their baby. You may prefer to breastfeed in a darkened room to reduce sensory overload. Nipple shields can also be tried, although you should speak to your midwife or health visitor about the pros and cons of using them as they can reduce the flow of milk to your baby. Give yourself time to adjust to the new feelings, and permission to try other options. 

Find out more about sensory sensitivities and advice for managing them here.

There are different options if you choose to breastfeed, from combination feeding (using a mix of breastfeeding and formula feeding) and pumping your breastmilk to feed with later. Breastfeeding isn’t right for everyone, and for some people, exclusively formula feeding is best.

Whether you choose to formula feed or breastfeed your baby, there is support for you. Ask your midwife or health visitor if you have questions or need advice.

If you take medication, ask your doctor if they are safe while breastfeeding. Many are safe to carry on taking. But some drugs can pass into breast milk in small amounts. You may be able to change the type or dose. 

Will my baby be autistic?

Autism sometimes runs in families and may be passed from parent to child. 

Experts don’t know what causes autism and many believe there isn’t just one cause. We do know that autism is not caused by bad parenting or by vaccinations.

If your child is autistic, you may notice signs in early childhood or this might not happen until they’re older. Your health visitor may spot signs when they do development checks at around 10 months and 27 months. These checks include looking at social and emotional development and communication.

You can learn about signs of autism in young children on the NHS website.

If you think your child may be autistic, speak to your GP, health visitor or any other health professional that your child sees so they can support the needs of you and your family.

Caring for an autistic child as an autistic parent may be challenging, but a small study of autistic mothers with autistic children found they felt more connected to their children, with a more in-depth understanding of their needs, because of their shared experience. 

Where can I get support?

While planning a pregnancy, your doctor can support you with questions or concerns. During pregnancy, they are still available, and you’ll also be able to speak to your midwife.

At this time, it’s normal to have worries about pregnancy loss. Speak to your health care providers if this is the case for you. 

You can also call the Tommy's Midwives' Helpline for free from 9-5, Monday to Friday. The line is staffed by our specialist team of midwives, for anyone who needs advice, reassurance or support on any pregnancy or planning for pregnancy issue, including mental health.

Call 0800 0147 800 or email [email protected].

Support after having a baby

A new baby changes your routine a lot, and as they grow and develop, their needs can keep changing. It can be hard to deal with for any parent. There’s a lot of new things to learn and do each day, and that can feel difficult.

Your GP is there to give medical advice, and your health visitor will visit you at home after your baby is born to offer you advice and  support. They will also be able to tell you about any local support services.

If you’re a first-time young parent, you may also see a family nurse who can offer support.

Some new parents find it hard to put things they read about into practice. If it helps, you could ask your health visitor to show you what to do instead of giving you printed leaflets. They could show you how to bath your baby, for example, if you haven’t been shown in hospital.

Ask friends and family for support to, if you can. It’s always good to ask for advice and tell someone if you feel you would like more help.

If you ever feel like your care is not right for your needs as an autistic person, let your healthcare team know. 

For more information and support, visit the NHS Autism Guide and National Autistic Society.