Factsheet: Neurodivergent and pregnant: how to make maternity care feel manageable (and how to ask for what you need)

Laura Spence

Founder and ADHD Midwife

NeuroNatal Academy C.I.C

@rosiewithapen

Summary

Pregnancy and birth can feel intense for anyone. Your body changes quickly, sleep can shift, appointments can pile up, and emotions can run high. If you’re neurodivergent (for example ADHD, autistic, dyslexic, dyspraxic, or you have sensory processing differences), you may find the maternity system itself can be one of the hardest parts. Not because you’re “too sensitive” or “not coping”, but because maternity care is often designed around neurotypical communication, sensory tolerance, and executive functioning.

The good news is that small, reasonable adjustments can make a big difference, and you are allowed to ask for them.

Why it can feel harder for neurodivergent people

Pregnancy and maternity care can increase “load” in three main ways:

Sensory load: bright lights, busy waiting rooms, buzzing monitors, hospital smells, scratchy gowns, touch, examinations, and multiple people talking at once.

Information load: new terms, risks and benefits, leaflets, consent discussions, and decisions made under pressure.

Executive function load: planning appointments, remembering questions, tracking symptoms, organising transport, switching tasks, and making decisions when you’re tired or overwhelmed.

When load gets too high, you might experience shutdown (going quiet, struggling to speak), agitation, tears, anger, “going blank”, or an urge to leave. This is your nervous system responding to overwhelm. It is not you being difficult.

What reasonable adjustments can look like in maternity care

Reasonable adjustments are small changes that remove barriers. You don’t need a perfect explanation or the “right words”. You can simply describe what helps your brain and body.

Here are examples that many people find useful.

• Communication adjustmentsAsk staff to use plain language and explain jargon.Ask for one question at a time.

  Ask for a written summary of key points, decisions, and the plan.

  Ask the staff to tell you what will happen next, in order.

  Ask for extra processing time before answering.

  Ask to record key parts of the conversation on your phone.

  Sensory adjustments

  Ask if there is somewhere quieter to wait, if available.

  Ask for dimmer lighting where possible.

  Wear headphones, earplugs, or sunglasses if it helps.

  Keep your clothing on where safe and appropriate and use your own blanket.

  Ask staff to tell you what will happen before an examination and agree a pause signal.

  Executive function adjustments

  Book appointments at a time of day when you function best, where possible.

  Ask if you can have one named point of contact, where possible.

  Bring someone to take notes or help you remember information later.

  Break decisions into steps. For example, “Today we decide X. Next time we decide Y.”

Your rights: adjustments are not a ‘favour’

In the UK, reasonable adjustments are not just a nice idea. They are part of the law. Under the Equality Act 2010, services (including NHS maternity services) have a duty to make reasonable adjustments for disabled people so that care is accessible and fair. Many neurodivergent people meet the legal definition of disability when their differences have a substantial, long-term impact on day-to-day life.

You can ask for adjustments to be written in your notes so you don’t have to explain every time. Some NHS services also use a Reasonable Adjustment Flag (NHS England) designed to record adjustments so they can be recognised across services that can access it. Not every service uses it consistently yet, but you can still ask.

Can you record my reasonable adjustments in my notes?

Do you use the Reasonable Adjustment Flag? If you do, can we add my adjustments?

Scripts you can copy and paste

If speaking feels hard, save these on your phone and show them to staff.

I process information better in short chunks. Can you give me the key points first?

Please tell me what’s going to happen next, step by step.

I get overwhelmed by lots of questions. Can we do one at a time?

I’m neurodivergent and sensory overload makes it hard for me to speak. If I go quiet, I’m overwhelmed, not refusing.

Can you write down the plan and the safety net advice before I leave?

I need a pause. Can we stop for 60 seconds and then continue?

Please document my reasonable adjustments in my notes so I don’t have to repeat them.

Making appointments easier on your brain

Appointments can move fast. You might have something important to say, then the moment comes and your mind goes blank. That’s not you being “bad at this”. That’s stress, time pressure, and trying to process lots of information at once.

A gentle way to support yourself is to go in with a tiny anchor. That might be one note on your phone that says “Please write down the plan” or “One question at a time, please.” If you have the energy, jot down the top one or two things you really need answered, not everything all at once. If you can only manage one question, that still counts.

At the start, it’s okay to say:

My brain drops information when I’m overwhelmed. Could you summarise the plan at the end?

If I go quiet, I’m processing. Please give me a minute.

Afterwards, try not to pressure yourself to remember it all. Ask for the basics in a way your brain can hold.

What are we doing next?

What should I look out for?

Who do I contact if I’m worried?

That’s enough.

Labour and birth: reducing overwhelm in real time

Labour is sensory. It’s physical, emotional, and often noisy and bright. It can feel unpredictable even when everything is going normally. For a neurodivergent brain, unpredictability can be the hardest part. So instead of trying to control the whole birth, focus on something more realistic: comfort, communication, and consent.

It can help to bring a few steadying items that signal safety to your nervous system. Headphones, an eye mask, a soft blanket, lip balm, a fidget, chewing gum, a water bottle. Nothing fancy, just familiar.

You can also ask for the kind of communication that helps you stay grounded, for example:

Please tell me what’s happening next in simple steps.

Can one person speak to me at a time?

If you need to do something, explain what it is, why, and what choices I have, then give me a moment to think.

If you have a partner, friend, or doula with you, they can be your spare brain. Not to speak over you, but to help you hold the thread: reminding staff what helps, asking for information to be repeated, and checking you’ve understood before you decide.

If you’re worried you’ll be seen as ‘difficult’

You are not “too much”. Needing clarity, quiet, or time is not unreasonable. It is part of safe, respectful care. If it helps, frame it like this:

These adjustments help me understand, consent, and cope, and that helps care go more smoothly.

Key takeaway

Neuroinclusion isn’t special treatment. It’s what makes care accessible. You deserve maternity care that your brain can hold, and asking for adjustments is a valid, practical form of self-advocacy.

If speaking is hard, show this sentence

I’m overwhelmed, and I need a pause. Please write down the plan and the next steps.