Understanding the experiences of receiving and providing maternity care for autistic adults: A Multi-perspectival Interpretative Phenomenological Analysis study

Available research suggests autistic mothers experience greater dissatisfaction with maternity care compared to non-autistic mothers. Limited research exists exploring autistic mothers' experiences of maternity care, and no research to date has considered maternity care professionals' experiences of delivering care to autistic mothers. This qualitative study aims to explore the experiences of receiving and providing maternity care for autistic mothers. Data were collected using semi-structured interviews with four autistic mothers and four midwives. Data were analysed using Multi-perspectival Interpretative Phenomenological Analysis. Three overarching themes emerged: 'challenges faced within maternity care, 'the importance of the caring relationship', and 'the challenge of navigating competing demands and priorities'. Findings highlight the unique challenges experienced by autistic mothers during labour and birth, the need for increased autism awareness in midwifery, and further suggest universal changes to the delivery of maternity care which would benefit autistic women. Autistic mothers may experience unique challenges when accessing maternity care. A better understanding of the experience of autistic mothers and maternity care professionals would help to create opportunities to support better maternity care. In this study, we interviewed autistic mothers and professional midwives, living and working across the United Kingdom and Ireland. In the interviews, the autistic mothers recalled challenges they faced in the hospital settings, difficulties in communicating their needs, and distress when being physically examined. The midwives we interviewed brought their personal experiences of autism (some were autistic themselves, while others had autistic family members) and made efforts to accommodate autistic mothers where possible. This included paying attention to potential sensory issues, trying to establish a relationship with the mothers and communicating what was going on without medical jargon. However, the midwives were limited in their ability to fully attend to the needs of autistic mothers due to time and resource restraints. Both the midwives and autistic mothers felt that midwife-led births were more attentive to the needs of mothers. Based on our findings, we recommend further training and awareness on autism in midwifery and suggest that changes relating to sensory and communication challenges would benefit both autistic and non-autistic. Our study provides important insight into this experience of maternity care from two perspectives and emphasises the need for greater inclusivity in maternity care services.