Maternal wellbeing during the perinatal period is an important public health concern due to its impact on both mother and child. For autistic women, who experience sensory and communication differences and can face barriers to healthcare, the perinatal period may pose unique challenges. Despite this, research into the parenthood experiences of autistic women is scarce. This thesis explores the perinatal experiences and wellbeing of autistic mothers, their parenting behaviours, and the development of their infants.

Chapter 1 reviews the literature, and Chapter 2 reports on qualitative interviews with both autistic (n = 24) and non-autistic women (n = 25). Compared with non-autistic women, autistic women reported greater challenges with the physical burden of pregnancy; including heightened sensory experiences, pain, and morning sickness. Autistic women reported a lack of autism understanding among healthcare professionals and a reluctance to disclose their diagnosis. Continuity of care, as well as clear communication surrounding their care, were highlighted as important support needs.

Chapter 3, an online survey study of autistic and non-autistic people’s perinatal experiences, explored whether the themes of Chapter 2 generalise to a larger sample using quantitative methods. Autistic women (n = 429) were more likely than non-autistic women (n = 551) to find the sensory and physical aspects of pregnancy and birth overwhelming and were more likely to experience perinatal depression and anxiety. They were also less satisfied with prenatal, birth-related and postnatal healthcare across a number of domains. They tended not to disclose their autism diagnosis to professionals and felt that professionals did not have a good understanding of autism.

Chapter 4 explores wellbeing at three time-points in autistic (n = 27) and non-autistic (n = 29) women: during the third trimester of pregnancy, 2-3 months after birth and 6 months after birth. Autistic women experienced greater self-reported stress, depression, and anxiety compared with non-autistic women. Explorations of self-reported parenting styles and parenting confidence revealed no significant group differences.

Chapter 5 finds no differences between autistic and non-autistic parents on parenting behaviours such as sensitive responsiveness, scaffolding, and affect during observations of play with their 2-3 month old and 6 month old infants. No group differences were found in infant social behaviour. This may reflect the coding method employed, or it may reflect that at this early stage in development no differences exist.

Chapter 6 explores associations between mothers’ perinatal wellbeing (stress, depression and anxiety) and structural MRI measures of their child’s brain development during the third trimester of pregnancy and 8-12 weeks after birth. For infants of both autistic and non-autistic mothers, associations were found between maternal wellbeing and the growth of brain regions implicated in mood disorders. This novel finding has important implications for perinatal care practice.

Overall, these studies show that the perinatal period can bring a number of challenges for autistic women, including navigating physical experiences and accessing adequate healthcare, and can leave them vulnerable to reduced wellbeing. The thesis provides evidence that autistic parents are not less likely to engage in positive parenting behaviours with their infants. Infants of autistic mothers show similar social interaction to infants of non-autistic mothers during the first 6 months of life, although the brain development of infants of both autistic and non-autistic mothers is influenced by their mothers’ wellbeing. Overall, the thesis highlights that access to adequate perinatal support is essential for both maternal wellbeing and infant development and illustrates the need for more research into autistic women entering parenthood as they have been neglected in research. Discussion centres on the need to translate this research into guidelines for perinatal care practice.