Pregnancy as an Autistic Woman: A Sensory and Emotional Overload

Bridgette Hamstead

Pregnancy is often described as a time of excitement and transformation, but for many autistic women, it can also be an overwhelming experience filled with sensory challenges, emotional upheaval, and an intense disruption of routine. While every pregnancy is different, the physical and emotional changes that come with it can be especially difficult for those of us who experience the world in an intense and heightened way. The sensory overload of pregnancy, combined with the unpredictability of medical appointments, social expectations, and the pressure to navigate an unfamiliar healthcare system, can make the journey to parenthood feel isolating and exhausting. Unfortunately, because much of the medical world is not designed with autistic patients in mind, many of us struggle to get the accommodations and understanding we need throughout pregnancy.

One of the most challenging aspects of pregnancy for autistic women is the constant and often unpredictable changes in the body. Many of us rely on a sense of physical stability to feel grounded, and pregnancy disrupts that in ways that can be difficult to process. The shifting weight distribution, changing hormones, and unfamiliar sensations can make us feel disconnected from our own bodies, triggering discomfort or distress. For those with heightened interoception, the internal sense of bodily awareness, every new symptom or physical change may feel overwhelming or even unbearable. The nausea, dizziness, fatigue, and body aches that come with pregnancy can be especially hard to cope with when they are felt so intensely. Many autistic women struggle to interpret bodily signals, making it difficult to determine what is a normal part of pregnancy and what might be a sign of a problem. This uncertainty can lead to anxiety, especially when healthcare providers do not take our concerns seriously.

Medical appointments are another significant challenge during pregnancy. The healthcare system is not designed for autistic communication styles, sensory needs, or anxiety levels, and many autistic women find themselves struggling to navigate it. Appointments often involve bright lights, long wait times, unfamiliar smells, and unexpected physical contact, all of which can be overwhelming. Many autistic women find it difficult to process spoken information in real time, especially in high-stress situations, making it hard to ask questions or advocate for themselves in medical settings. Doctors may assume that a patient who does not express pain or distress in expected ways is not struggling, leading to a lack of accommodations or appropriate medical care. Some autistic women mask their discomfort during appointments, trying to appear calm and in control even when they are deeply overwhelmed, only to experience a complete shutdown afterward.

The emotional shifts that come with pregnancy can also be particularly intense for autistic women. Many of us already experience emotions in a deep and powerful way, and the hormonal changes of pregnancy can amplify this to an extreme. Mood swings, increased anxiety, and difficulty regulating emotions can make it hard to function, especially when combined with sensory overload. Pregnancy often comes with increased social expectations, with friends, family members, and even strangers offering unsolicited advice, touching the belly without permission, or making comments about the pregnant person’s body. The pressure to engage in small talk about pregnancy, answer personal questions, or participate in traditional pregnancy-related social activities can be exhausting and overwhelming for autistic women who struggle with social interactions. The expectation to express excitement and joy at all times can feel impossible when pregnancy is experienced as a deeply uncomfortable and anxiety-inducing process.

One of the most difficult aspects of pregnancy for many autistic women is the loss of control over routines and sensory environments. Pregnancy often disrupts sleeping patterns, changes appetite and food preferences, and brings new limitations on physical activity. For those of us who rely on strict routines to feel safe and regulated, these sudden shifts can be incredibly distressing. Sensory sensitivities to food can make morning sickness even harder to manage, as the list of tolerable foods may become even smaller. Smells that were once neutral may become unbearable, and textures that were once comforting may suddenly feel intolerable. The unpredictability of cravings and aversions can be frustrating, especially when it feels like the body is no longer responding in expected ways.

Labor and delivery present another set of sensory and emotional challenges. The unpredictability of when labor will begin, how it will progress, and what interventions may be necessary can be overwhelming for autistic women who need predictability and clear expectations. Hospitals are full of bright lights, beeping machines, strong smells, and constant interruptions, all of which can be overstimulating. Many autistic women struggle with sensory overload during labor, finding it difficult to communicate pain levels, process instructions from medical staff, or cope with unexpected medical procedures. The lack of control over one’s body during labor can be deeply distressing, especially when medical professionals do not provide clear explanations or respect personal boundaries. Some autistic women describe feeling like they are being talked over or not being given enough time to process decisions before interventions are performed. Others experience shutdowns or dissociation during labor due to the overwhelming sensory and emotional experience.

Despite these challenges, many autistic women find ways to navigate pregnancy in a way that works for them. Finding an autistic-friendly healthcare provider who is willing to listen and accommodate specific needs can make a significant difference. Requesting written instructions, bringing a support person to appointments, and advocating for sensory-friendly accommodations can help reduce stress. Preparing for labor with detailed birth plans that outline communication preferences, sensory needs, and medical boundaries can help autistic women feel more in control of the process. Leaning into special interests, engaging in repetitive or comforting activities, and creating a predictable postpartum plan can help manage the transition to parenthood.

There is still very little research or discussion about pregnancy in autistic women, but that does not mean our experiences are any less valid. Many of us struggle in silence because the dominant narratives about pregnancy do not reflect our reality. The assumption that pregnancy is universally joyful and exciting can make it difficult to express discomfort, anxiety, or frustration without being met with judgment. Autistic women deserve to have their unique experiences acknowledged and accommodated in medical settings, social spaces, and conversations about pregnancy. The more we talk about these challenges, the more we can push for change in how autistic people are supported through pregnancy, childbirth, and parenting.

Pregnancy can be overwhelming, but it is not something we should have to navigate alone. Finding community with other autistic parents, seeking out neurodivergent-friendly resources, and giving ourselves permission to experience pregnancy in whatever way feels natural to us can make the journey more manageable. There is no single way to experience pregnancy, and there is no right or wrong way to feel about it. What matters most is recognizing our needs, advocating for accommodations, and creating an environment that supports us in the ways we need. Autistic pregnancy experiences are real, valid, and deserving of recognition and understanding.

Recommendations for Navigating Pregnancy as an Autistic Woman

1. Find an Autistic-Friendly Healthcare Provider
   Look for a doctor or midwife who listens, validates your experiences, and is willing to accommodate your sensory and communication needs. If possible, seek out providers who have experience working with autistic patients or who are open to learning about neurodivergent needs. If you feel dismissed or invalidated, do not hesitate to switch providers.

2. Prepare for Medical Appointments
   Medical visits can be overwhelming due to sensory overload and communication challenges. Bringing written notes with your questions and concerns can help you stay on track. If processing verbal information is difficult, ask your doctor to provide written instructions after appointments or have a trusted support person with you to help take notes.

3. Advocate for Sensory Accommodations
   Medical environments can be overstimulating, so do not be afraid to request adjustments that make you more comfortable. This may include dimming lights, avoiding unnecessary physical touch, requesting a quiet exam room, or wearing noise-canceling headphones during long waits. If you struggle with being touched, let your provider know so they can approach physical exams in a way that feels safer for you.

4. Plan for Sensory Challenges
   Pregnancy often heightens sensory sensitivities, so prepare for potential changes. Stock up on foods that are safe for you, as aversions and cravings may shift unpredictably. If certain smells become intolerable, carry essential oils or scented items that you find grounding. Adjust clothing choices if textures start to feel uncomfortable, and consider soft fabrics or loose-fitting options.

5. Create a Predictable Routine
   Pregnancy can bring a lot of unpredictability, which can be distressing for autistic women who rely on structure. Establishing a daily routine that includes rest, meals, movement, and quiet time can help maintain a sense of stability. Having a structured plan for your medical appointments, prenatal classes, and postpartum support can also help reduce anxiety.

6. Use Communication Strategies That Work for You
   If spoken communication is difficult, consider using text, email, or written notes when interacting with your healthcare team. If you find it hard to express pain or discomfort in medical settings, use a pain scale or a written description of your symptoms to communicate your needs more effectively.

7. Prepare for Social and Emotional Changes
   Pregnancy often comes with increased social attention, which can feel overwhelming. If you are uncomfortable with unsolicited advice, comments about your body, or unwanted touch, set firm boundaries with family, friends, and strangers. You can prepare simple scripts to decline intrusive questions or physical contact.

8. Develop a Birth Plan That Includes Sensory and Communication Needs
   Labor and delivery can be an overwhelming experience, so having a detailed birth plan can help you feel more in control. Include preferences about lighting, noise levels, touch, and medical interventions. Let your birth team know if you need extra processing time for decisions or if you may go nonverbal under stress.

9. Have a Postpartum Plan in Place
   The transition to parenthood can be overwhelming, so plan ahead for support. Identify trusted people who can help with meals, household tasks, or childcare in the early weeks. Prepare for potential sensory overload with strategies such as noise-reducing headphones, a dimly lit space for recovery, or time alone when needed.

10. Connect with Other Autistic Parents
    Finding a community of other autistic parents can provide invaluable support and validation. Online forums, social media groups, or local neurodivergent parenting networks can offer advice, shared experiences, and a sense of connection. Knowing you are not alone in your experience can make a huge difference.

11. Give Yourself Permission to Experience Pregnancy on Your Terms
    Every pregnancy is different, and you do not have to fit into societal expectations of what pregnancy "should" feel like. It is okay if you do not feel glowing, excited, or social. It is okay if you need extra support, if your sensory sensitivities increase, or if your emotions feel out of control. Your experience is valid, and you deserve care, understanding, and accommodations that allow you to navigate pregnancy in a way that works for you.

    Scripts for Communicating Pregnancy Needs as an Autistic Woman

    To a Healthcare Provider

    Requesting Accommodations for Sensory Sensitivities
    "I have sensory sensitivities due to autism, and medical environments can be overwhelming for me. If possible, I would appreciate a quiet exam room with dim lighting. I also prefer clear, step-by-step explanations before any physical exams so I can mentally prepare."

    Explaining the Need for Written Instructions
    "I sometimes struggle to process verbal information in real time, especially in high-stress situations. It would be really helpful if you could provide written instructions or a summary of what we discussed after each appointment so I can review it later."

    Advocating for Communication Needs
    "I need a little extra time to process information and respond to questions, so if I pause before answering, that’s why. It helps if you give me a moment before moving on to the next topic."

    Expressing Discomfort with Unnecessary Touch
    "Physical touch can be difficult for me, especially when it is unexpected. Please let me know before touching me or conducting any exams so I can prepare myself."

    Requesting Time to Process Medical Decisions
    "I sometimes need more time to think through medical decisions. If a choice needs to be made, I’d appreciate having the information in writing so I can go over it at home and come back with questions."

    To a Partner or Family Member

    Setting Boundaries for Sensory Overload
    "Pregnancy has made my sensory sensitivities much stronger, and I get overwhelmed easily. I need a quiet space to decompress sometimes, so if I step away, please know it’s not personal—I just need to reset."

    Explaining the Need for Routine and Predictability
    "I rely on routines to feel comfortable, and pregnancy has disrupted a lot of them. It helps me if we can keep certain things predictable, like meal times, rest breaks, or planning appointments in advance."

    Requesting Help with Overwhelming Tasks
    "I am struggling with [cooking, cleaning, errands] right now because of pregnancy exhaustion. Could you help with [specific task] so I can focus on resting?"

    To Friends, Acquaintances, or Strangers

    Responding to Unwanted Belly Touching
    "I’m not comfortable with people touching my belly, even if it’s meant kindly. Please respect my space."

    Declining Unsolicited Advice or Pregnancy Conversations
    "I appreciate that you want to share advice, but I am already feeling overwhelmed with information. Right now, I just need to focus on what works for me."

    Deflecting Overwhelming Social Situations
    "I am feeling overstimulated today, so I need to step away from socializing for a bit. I appreciate your understanding."

    To a Birth Team or Hospital Staff

    Advocating for Sensory-Friendly Labor Conditions
    "Bright lights and loud noises make it harder for me to focus and regulate during labor. If possible, I’d like dim lighting and minimal background noise in the room."

    Communicating Pain and Sensory Overload During Labor
    "I may struggle to verbally communicate my pain levels or discomfort during labor. If I become quiet or withdrawn, please check in and offer written options for how I can communicate what I need."

    Asserting the Need for Processing Time Before Medical Interventions
    "I need extra time to process medical information and make decisions. Please explain things slowly and allow me time to think before making any choices about interventions."