• have an open discussion about being autistic and your specific support needs and preferences with your healthcare provider(s) as early as possible 
• create and carry a health passport or other care document to help communicate your needs 
• having an autism diagnosis might help in explaining particular needs 
• bring a supportive person with you to appointments 
• record appointments if this is helpful – you could use a ‘voice memo’ app on your phone
• consider hiring a doula and/or independent midwife who can advocate for your needs and support communication with healthcare professionals 

• request a tour of the hospital you plan to give birth in ahead of time (this is standard, but you may wish to request a tour earlier in your pregnancy, or more than one tour) 
• bring sensory comfort items from home to the hospital 
• prepare yourself for the different possible options for interventions and outcomes. Pregnancy and childbirth can be unpredictable, so it can help to be open to a range of options as it may not be possible to follow one particular birth plan 
• read about other autistic people's experiences of pregnancy and childbirth (see the section ‘Insight from autistic people’ below) 
• be aware that representations of ‘perfect’ or ‘magical’ experiences of pregnancy and childbirth in pop culture and brand marketing may not be realistic. 

"The biggest struggle with being autistic and pregnant is not realising that your needs are not being met. … Looking back, I realise the problem was not in how the doctors did their job but in how everything was explained to me. … The most important step is to find a support system, no matter how small it may be. Having loved ones that know your wants and needs can help when you are unable to communicate that to doctors and staff. … Make sure that your doctor understands the way you communicate and what you want to happen during and after delivery. … Make sure to ask questions when something does not make sense, no matter if you have asked it 20 other times." 

– Alicia Trautwein, Motherfigure

"With my youngest daughter I had a home birth, and due to a very fast labour, the midwife only arrived with about ten minutes to spare. When she came in, I calmly explained how close my contractions were and how I thought I was ready to push. Afterwards she confided that I was so calm that she thought I was talking utter nonsense, until she saw the next contraction and literally ran to my side. Two more contractions and there was a baby! It can be difficult when people expect you to be performing your pain in a way they recognise at a time when you have nothing spare to spend on doing the right facial expressions!” 

– Rhi Lloyd-Williams, Learn from autistics

"Have an open discussion about being autistic with your care provider early on if you can. The NHS can be slow moving and ... you are more likely to have your needs met if you ask early, clearly and repeatedly. Give your healthcare professionals information on your needs and required accommodations, this can be written down if you find it difficult to speak or communicate your thoughts during appointments." 

– Ruth Jenks, Autistic Parents UK

"I would absolutely recommend hiring a birth doula (or bringing along a friend or family member) who understands your sensory experience and communication needs. A birth doula can support you to manage your pain, advocate to hospital staff on your behalf and relay information to you in a way that you are able to process. You will also have developed a relationship with your doula throughout your pregnancy so will likely feel safe with them.  Your doula will also be able to support your partner, if you have one." 

– Linda Hollenberg, Reframing Autism

"Since receiving my autism diagnosis, I have given birth to my second child. I was able to discuss my sensory and communication difficulties with the midwives before the birth and the whole experience was amazing. I have received the support that I should have had the first time around. … I still find situations challenging but my awareness of myself has taken the edge off." 

– Lucy Parker, Motherly

"One autism-specific thing that I've done is I created … a care document which I sent to the midwives to try and help them understand a little more about how autism affects me. Because: I said to them that I'm autistic, but unless they know what that means then you've got no idea what you're actually communicating with that. So I thought it was very important that I said, 'I'm autistic, and I'm autistic like this.' And I think that is important for all autistic people to communicate with their doctors…" 

– Yo Samdy Sam, Autistic and pregnant

"The kind of things I would say [in a care document are: 'I'm often in way more pain that I will communicate through my facial expressions' … ;  'I don't understand pain scales from one to ten' …; 'If I'm suffering mentally, if I'm really depressed or anxious… I will often downplay this' …; 'Please don’t touch me without asking' …; 'Please don't administer drugs or injections without explaining exactly what they are for and why I need them, and whether I need them or whether it's recommended.'" 

– Yo Samdy Sam, Autistic pregnancy: how I coped

"Many autistic people are hypo- or hyper-sensitive to a lot of stimulus, including pain, and we might not react in the way that it's expected of us to react when in pain. So it's really problematic if somebody is assessing how much pain relief we might need, especially during labour, based on the facial expressions that we're making. … There is no guarantee that people will pay attention to a care document, but at least having listed it out helps people like a partner – or if you have a doula helping you – helps them know how to advocate for you." 

– Yo Samdy Sam, Autistic pregnancy: how I coped

"What I've been trying to do in this pregnancy is … make sure I have all of the information to make informed decisions. … For example, I got booked in for a glucose tolerance test… and it's drinking three days' worth of glucose in five minutes ... and then you have to sit in the hospital waiting room for three hours. … the drinking itself would be too sensory for me, I wouldn't be able to cope with that, and then I would also not be able to sit in a waiting room in a hospital like that, not being able to move. I then had to go off and do my own research into the glucose tolerance test, any alternatives you can do… and I'm now having a fasting glucose blood test as an alternative because the drink just wasn’t suitable for my autism and my needs." 

– Savannah, Becoming Autism

“I loved the thought of being a mum but I hated the experience of being pregnant. I had to take anti-sickness medication so I could keep ice chips down due to hyperemesis gravidarum. From speaking to other mums, I think this is surprisingly common among autistic women, but is considered less common in the non-autistic population. ... I’ve always had a strong sense of smell, and although sensitivity to smell increases for most people during pregnancy, I was so impacted that I had to wear earplugs in my nose and learn to breathe through my mouth in my first trimester.” 

– Rachel Townson, Stories from the spectrum

"…one thing I would say I found incredibly reassuring during pregnancy was to just get my hands on as much information as I could about pregnancy …, and later in the pregnancy about new babies and how to care for them. Just research, research, research, so that I could feel confident that I knew what was happening, I knew what to expect, I knew what was likely to come next – and that helped me to manage my anxiety around it and to cope with it. ... 

My experience is that you can do things to tip the balance more in favour of the kind of birth that you want – yoga will be helpful, staying active will be helpful – but ultimately, your baby is going to come how it's going to come, and there's not really a huge amount you can do about that. … When you are at that point where you are planning the birth and you are thinking about how you would like it to be, have ideas, but don't get overly attached to them; because, if you can be more chilled about what's going to happen, it's going to be much less stressful…” 

– Purple Ella, AUTISM AND PREGNANCY