What is it about?
Autistic women face higher risks during pregnancy and childbirth, and the way health professionals communicate with them may be part of the reason. We interviewed 34 autistic women from all regions of Brazil about their care during pregnancy, birth and the months after. The group included women who need more support in daily life and women who communicate mainly through writing, pictures or communication devices. Each interview was adapted to the person: video call, written messages, a face-to-face meeting or augmentative and alternative communication. The women described specific communication needs, such as difficulty recognising and naming bodily sensations, strong reactions to noise, light, smells and touch, and a need to know in advance what will happen. They told us how often these needs went unrecognised, and also what changed when professionals adapted their way of working.
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Why is it important?
The women’s accounts show that the main problem is not in how autistic women communicate, but in how health services are organised to listen. Advice such as “go to the hospital if you feel a headache” does not work for someone who cannot easily identify that sensation. Participants described complaints being dismissed as exaggeration, being touched after asking not to be, and professionals speaking to their mother or partner instead of to them. Women who do not use speech described feeling invisible. These experiences matter for safety, because warning signs can be missed, and for mental health, because birth can become traumatic. The good examples were simple and cheap: appointments at an exact time, a coloured chart of pregnancy weeks, a doula relaying agreed signals, permission to bring written questions. Most research on this topic comes from high-income countries. This study brings the voices of Brazilian women, including those who are usually left out of research.
Perspectives
As an obstetrician, I learned from these women that much of what we call “difficult patients” is in fact a mismatch between our routines and their way of processing the world. None of the adaptations they valued required expensive technology. They required time, predictability, consent before touch and the willingness to ask questions differently. I hope this work encourages maternity teams to plan communication with autistic women from the first prenatal visit, as part of the care plan rather than as a favour, and encourages researchers to include women with higher support needs and those who communicate without speech.
ALINE BRILHANTE
Universidade Federal do Ceara
Read the Original
This page is a summary of: Communication barriers in perinatal care for autistic women: A qualitative study using the hermeneutic-dialectic circle in Brazil, PLOS One, September 2026, PLOS,
DOI: 10.1371/journal.pone.0358429.
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