“We Carry the Burden of Doing Right, Doing Wrong, and the Guilt That Follows”: A Qualitative Study of Postpartum Experiences of Autistic and Non-Autistic Mothers

Abstract

The intersection of autism and motherhood/parenthood remains largely underexplored, particularly within the Spanish context. Autistic mothers and birthing parents are often silenced, with limited representation and scarce accessible information, contributing to a broader social and institutional unawareness. This study explores the postpartum experiences of autistic and non-autistic mothers during the first two years following childbirth. Twelve semi-structured interviews were conducted with six autistic and six non-autistic mothers and analyzed using Reflexive Thematic Analysis. Three key themes were constructed, as follows: (1) Ups and Downs: Navigating Emotional and Sensory Experiences, highlighting the intense sensory and emotional load of early motherhood; (2) Lack of Information and Support: The Root of Increased Vulnerability, addressing gaps in institutional support and knowledge; and (3) The Social Dimensions of Early Postpartum: Tensions and Expectations, focusing on family and societal pressures as well as identity struggles. While experiences overlapped in several areas, two tentative distinctions were observed, as follows: autistic mothers appeared to favor self-guided strategies (e.g., books, personal guidelines), whereas non-autistic mothers relied more on professional guidance; additionally, autistic mothers expressed a stronger preference for autonomy, while non-autistic mothers often valued companionship. These findings underscore the urgent need for healthcare professionals to receive training on autistic motherhood/parenthood and for the development of tailored postpartum care guidelines to ensure inclusive, responsive support.

1. Introduction

Autistic mothers and birthing parents often face triple discrimination, namely as women or dissident-gender individuals (in a society still shaped by sexist attitudes), as mothers or birthing people (within a culture steeped in rigid expectations and stereotypes about motherhood/parenthood), and as autistic individuals (amid widespread myths and a general lack of understanding of autism) [1,2,3]. In this regard, motherhood/parenthood remains a neglected area of study—especially when autism is involved:

“Motherhood (and the right to exercise it) becomes a source of discrimination for women in general, and for disabled [or neurodivergent] women, it often entails serious and even harmful consequences”.

[4] (p. 9)

Disabilities—as cited above—are increasingly understood through a social model, which emphasizes that many of the challenges faced are not inherent to the body itself but arise from systemic barriers, social exclusion, and oppression [5]. When these dynamics intersect with motherhood/parenthood, the marginalization becomes even more pronounced, yet it remains underexplored in both scholarship and policy. There is widespread societal ignorance about the specific needs of individuals who identify as autistic when it comes to choosing to become mothers/birthing parents [4]. Among all stages, postpartum is perhaps the most overlooked period in research on neurodivergent individuals, despite being a time marked by profound physical, hormonal, mental, emotional, psychological, and social changes. Scholarship on autistic parenting and early motherhood/parenthood are expanding, with most studies conducted in Anglo-Saxon contexts [6,7]. In recent years, research specifically focused on the postpartum experiences of autistic women and birthing people has been growing [8,9,10,11,12,13]; however, it remains scarce in the Spanish context.

This lack of visibility for autistic mothers and birthing parents becomes even more concerning considering the co-occurring conditions often associated with the perinatal and postnatal periods (e.g., depression). The limited understanding of autism among healthcare professionals, combined with the heightened sensory processing changes characteristic of this period, may increase the risk of postpartum depression [8,14]. Furthermore, societal expectations of maternal perfectionism (the “good mother”) and feelings of inadequacy—frequently reinforced by cultural norms—can become an additional significant physical and emotional strain, as well as a source of stress [15,16]. These pressures may hinder autistic mothers and birthing parents from seeking appropriate help when experiencing symptoms of postpartum depression [17,18,19].

In a study by Pohl et al. (2020) comparing the experiences of autistic and non-autistic women, some autistic mothers reported feeling that motherhood was isolating and difficult to manage. Perceived stigma and fear of being seen as “bad mothers” may discourage autistic mothers from seeking the personalized support they need—or lead them to camouflage their struggles [11]. Camouflaging involves both conscious and unconscious strategies used to navigate social contexts while concealing autistic traits [20]. Ramos-Serrano and Garcia-Molina (2025) note that many autistic mothers choose to hide their diagnosis out of fear of being judged as incompetent—even by those closest to them [1]. McDonell and DeLucia (2021) estimated that over 80% conceal their diagnosis, which can deepen the sense of isolation during this period [10]. Compounding this, most autistic women and birthing people are diagnosed late in life [2], often following their child’s autism diagnosis or because the intensification of their own traits during early motherhood/parenthood [3]. Thus, in the postpartum period, some autistic mothers and birthing parents could face at least two major identity shifts, namely transitioning into motherhood/parenthood and integrating their autistic identity [1]. However, although this could act as a trigger, it seems that for most mothers and birthing parents a formal diagnosis is not typically received until later, often during their child’s early years [3].

The fact that mothers/birthing parents and their children share the same diagnosis brings a number of strengths, as highlighted in international studies [3,21]. Among these are an intuitive understanding of the child’s experience and an enhanced ability to meet their needs [1,22]. Marriott et al. (2022) examine the experiences of parents with significant autistic traits and note that sharing an autistic identity with their children can be both beneficial and challenging [23]. Winnard et al. (2022) also emphasize these advantages, as the shared experience may foster a strong and intense parent–child bond [1,22,24]. Autistic mothers and birthing parents express love and concern for their babies, often describing a need for time to recover physically and emotionally before taking on the care of the newborn. This can result in a bonding process that is unique and adaptive [8]. However, some autistic mothers and birthing parents may feel guilty upon receiving their child’s diagnosis, fearing that their child will face similar difficulties to those they have experienced [1,22]. Despite the similarities highlighted in some studies, it is also important to remember the well-known phrase, “If you’ve met one autistic person, you’ve met one autistic person” (Shore, as cited in National Autistic Society, 2020 [25])—mother/birthing parent and child do not necessarily share the same traits or challenges. For instance, Ramos-Serrano and Garcia-Molina (2025) points out differences in sensory profiles between mothers and daughters, which may make early caregiving particularly exhausting [1].

In relation to sensory experiences, breastfeeding during the postpartum period is an intimate yet often overwhelming sensory event, making it particularly challenging for many autistic mothers and birthing parents [12]. Although breastfeeding is considered “natural”, this does not mean that it is easy, and many women face difficulties. Autistic women and birthing people may encounter additional barriers compared to neurotypical mothers and birthing parents. Some reported that their sensory needs were disregarded by professionals [9,26]. Demartini et al. (2024) analyzed birth and postpartum experiences in autistic and non-autistic women, finding that negative sensory experiences had a lasting impact. Notably, their results showed that only among autistic women did sensory sensitivity increase during the postpartum period—the time in which breastfeeding typically occurs [27].

Despite reporting heightened tactile sensitivity during the postpartum period, many autistic mothers and birthing parents still chose to breastfeed. This suggests a strong motivation and deep commitment—often involving considerable effort to adapt to a system that insufficiently accommodates their specific needs—prioritizing their child’s wellbeing over their own and seeking ways to foster their child’s confidence [1,9,26]. At the same time, it is important to acknowledge that sensory challenges, pain, and interoceptive differences—exacerbated by a lack of support—made breastfeeding impossible for some [1,28,29].

Autistic mothers and birthing parents reported feeling a lack of support in infant care, including difficulties understanding their baby’s facial expressions and connecting emotionally with their child [28]. It is crucial for professionals to provide this support and understanding [9], emphasizing the need for up-to-date knowledge about autism among healthcare providers [3]. Regarding support, Ramos-Serrano and Garcia-Molina (2025) also highlight the absence of an autistic community during the early stages of motherhood/parenthood, as well as a general lack of social support in parenting—an issue noted in previous studies [1,26].

It is only in the past decade that scientific literature by and for autistic mothers and birthing parents has begun to emerge—most of it focused on English-speaking populations [29]. This lack of focus leaves this group largely neglected, which is especially concerning given the urgent need to provide them with appropriate care tailored to their specific characteristics. Therefore, this study primarily aims to give voice to autistic and non-autistic Spanish mothers by describing, analyzing, and comparing their experiences during the postpartum period, focusing on the stage when they transition into motherhood and the following two years.

2. Materials and Methods

2.1. Participants

A total of 12 women between the ages of 30 and 44 participated in the study (M = 38.3; SD = 4.12). All participants were Spanish nationals and biological mothers. The sample was divided into two groups, with one composed of autistic mothers (N = 6) and the other of non-autistic mothers (N = 6). All six autistic participants had received a formal autism diagnosis from professionals specializing in autism and gender perspectives. Each had received their diagnosis in adulthood². This sample size aligns with established qualitative research practices [12,22], where smaller, carefully selected samples allow for an in-depth exploration of participants’ experiences. Including equal numbers of autistic and neurotypical participants helped maintain a manageable scope for detailed analysis. Moreover, autistic mothers and birthing people in Spain represent an underexplored and often difficult-to-reach population, making this carefully recruited sample particularly valuable for generating rich insights.

The inclusion criteria for the study were as follows: (i) being a mother/birthing parent, (ii) having a diagnosis of autism for the first group and not having one for the second, (iii) being over 18 years of age, and (iv) being a Spanish speaker. The children’s ages ranged from 2 to 17 years across both groups; however, most of the experiences recalled were from the youngest children. There was no inclusion criterion regarding the timing of diagnosis (whether before or after the postpartum period); however, some mothers received their diagnosis during the postpartum period (N = 2), others when their children were still at an early age (N = 3), and only one autistic mother (N = 1) before having her daughter.

To ensure comparability between groups, autistic mothers were interviewed first. Based on their demographic characteristics, non-autistic mothers were then selected and matched according to the following parameters: (i) similar age of mothers, (ii) similar age of children under 4 years old (for children over 6, a maximum age difference of 3 years was allowed), (iii) number of children, and (iv) mode of birth experience (cesarean or vaginal birth), in order to minimize its influence on reported postnatal experiences.

Regarding their relationships, all non-autistic mothers identified as heterosexual. Among the autistic mothers, four identified as heterosexual and two as bisexual; however, all were in a relationship with a man. In both groups, five mothers were in a relationship with the father of their children. More details are provided in

Table 1. Demographic characteristics of participants.

Autistic Mothers				Non-Autistic Mothers
Group	Age (Diagnosis Age)	N. Children (Age Range)	Mode of Birth	Group	Age	N. Children (Age Range)	Mode of Birth
Autistic mother 1	41 (40)	3 (8–17)	Vaginal and cesarian	Non-autistic mother 1	39	3 (6–17)	Vaginal and cesarian
Autistic mother 2	36 (34)	1 (4)	Vaginal	Non-autistic mother 2	35	1 (3)	Vaginal
Autistic mother 3	35 (34)	3 (5–17)	Vaginal	Non-autistic mother 3	44	3 (6–19)	Vaginal
Autistic mother 4	40 (30) *	1 (4)	Vaginal	Non-autistic mother 4	43	1 (3)	Vaginal
Autistic mother 5	35 (35)	1 (2)	Cesarean	Non-autistic mother 5	30	1 (2)	Cesarean
Autistic mother 6	41 (40)	1 (2)	Vaginal	Non-autistic mother 6	41	1 (2)	Vaginal

* Only one autistic mother had received her diagnosis prior to becoming a mother.

.

2.2. Materials

The research team—composed mostly of autistic members, students, professionals, researchers, and collaborators—developed a semi-structured interview guide. This research was conducted using a participatory approach, in which the autistic community played a central role—both as active members of the research area “Autistic Women and Gender Dissident Individuals” (MEIGA, as an acronym in Spanish, coordinated by the second author of this manuscript) and through the direct involvement of autistic individuals at various stages of the process.

The questions were reviewed by professionals with expertise in the field and shaped by the perspectives of the autistic women participating in the study.

The interview was organized into three thematic blocks, namely diagnosis, relationships, and motherhood. The present study focuses specifically on the third block, addressing the challenges faced by autistic mothers and birthing parents from the immediate postpartum period up to two years after birth. The interview included both general and specific questions. The questions specifically addressed the postpartum period; nevertheless, additional responses were analyzed whenever participants provided information related to postpartum and researchers could add other questions to help the conversation flow. The following questions are used:

(1)

How did you experience the postpartum period during the first months at home? (general question)

(1a)

Did you feel that you had support during this stage? (specific question)

(2)

How was your postpartum care experience? (general question)

(2a)

Did healthcare professionals provide you with postpartum follow-up? (specific question)

(3)

How was your mood during the postpartum period? (general question)

(3a)

Did you experience any symptoms of depression during this stage? (specific question)

(4)

What type of feeding did you use for your baby? (general question)

(4a)

Did you use breastfeeding, formula feeding, or a combination of both? (specific question)

(4b)

How long did it last? (specific question)

(4c)

Did you face any challenges with breastfeeding/feeding? (specific question)

(5)

Would you like to add anything else about your postpartum experiences? (general)

(5a)

Do you have any advice or information for an autistic mother going through the postpartum period? (specific question)

Participants were informed about the anonymity of the study and the protection of their personal data. All questions were open-ended, allowing them to share their experiences freely, without time or word limits. They were also informed that, once the interviews were transcribed, they would have the opportunity to modify or even partially or fully withdraw their responses.

2.3. Process

Ethical approval for the study was granted by the Ethics Committee of Universitat Jaume I, in accordance with the Declaration of Helsinki.

For the recruitment of autistic mothers, five organizations working with autistic women and birthing people were contacted. Following their approval, potential participants were approached via email and provided with detailed informed consent. Interestingly, all autistic mothers preferred to conduct the interview in synchronous formats, either face-to-face (N = 2), via video call (N = 1), or via instant messaging (N = 2). These formats allowed for more direct interaction and facilitated the expression of their experiences in a respectful manner—following the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) guidelines [30].

For the non-autistic mothers—recruited after the analysis of the autistic sample—participants were selected using convenience and snowball sampling strategies. Recruitment was carried out primarily through family members, friends, and acquaintances who matched the characteristics of the autistic mothers (e.g., age, number of children, and type of delivery). These participants also received the necessary information to ensure they understood how their personal data and narratives would be used. They were contacted via WhatsApp, and their accounts were collected through different formats, including video calls (N = 3), synchronous voice messages sent via WhatsApp (N = 1), and written responses (N = 2).

For all participants, the goal was to create a safe environment, both physically and psychologically, while accommodating participants’ needs to balance motherhood and work responsibilities. Questions were designed in an open-ended format to enable participants to share their experiences without time constraints. The motherhood segment generally lasted around 45 min, except for two interviews that extended to 2 h, conducted over 2 separate days to respect participants’ family–work balance, with one conducted in person and the other via WhatsApp (written).

2.4. Data Analysis

This study is grounded in a constructivist and interpretivist epistemological stance, understanding that knowledge not as something to be discovered, but as co-constructed through interaction between the researcher and participants. Rather than seeking objective or universal truths, the analysis acknowledges the active role of the researcher’s subjectivity, values, and positionality in the process of knowledge production.

The study is guided by a social justice-oriented approach [31], aiming to give voice to underrepresented experiences—particularly those of autistic mothers and birthing parents—and to generate rich, contextualized understandings of their lives. Although the findings are not intended for statistical generalization, the insights gained are considered potentially transferable to similar contexts, offering valuable contributions to research, professional practice, and public policy design that is sensitive to neurodiversity/disability.

A flexible qualitative design was used, following Reflexive Thematic Analysis (RTA) [32,33], which allowed for an inductive approach to the data. The study initially began with interviews with autistic mothers, but the preliminary analysis revealed unexpected and relevant themes. In addition, scholarly and community feedback suggested the value of including non-autistic mothers, which led to their subsequent inclusion. We did not seek data saturation, as we consider the concept incompatible with the interpretivist foundations of RTA [34]. Between-group comparison enabled targeted analytic contrasts to address research questions about difference and commonality. Comparisons were performed as interpretive analytical moves (patterns, contexts, and possible mechanisms) rather than as tests of population-level differences.

All these decisions align with the exploratory and reflexive logic of RTA, which conceptualizes research as a dynamic process in which the design may evolve in response to emerging findings, rather than being driven by a goal of direct comparison. For this purpose, the process followed the six steps of RTA, which included (i) familiarization with the data, (ii) initial coding, (iii) organization of codes, identification of patterns and themes, (iv) review, (v) writing the results, accompanied by the most relevant quotes, and (vi) validation of the narrative. As part of our participatory approach, findings were shared with participants through member checking and further validated through triangulation between autistic and non-autistic members of the research team. To ensure clarity in citations and to distinguish between autistic and non-autistic mothers, descriptive labels were used when identifying participants.

This study aligns with the Standards for Reporting Qualitative Research (SRQR [35]), covering approach, researcher characteristics, context, ethics, data collection, processing and analysis, and trustworthiness.

2.5. Community Involvement

Most individuals involved in the group’s studies—including several authors, researchers, collaborators, and translators—are autistic, and also autistic mothers. The project was shaped through personal discussions with community members, and the semi-structured interview schedule was co-developed with autistic women and gender-dissident individuals. Findings were shared with participants (member checking), and multiple meetings were conducted to integrate the feedback received. Results will be presented at university meetings to support autistic women and birthing people.

Our positionality fostered a strong commitment to centering autistic perspectives, particularly those of autistic mothers/birthing people, while also shaping the questions we asked and the ways we engaged with participants. We recognize that this closeness to the community requires careful reflexive awareness of our own assumptions and interpretations. At the same time, it may enrich the relevance and authenticity of the research by enabling us to relate more directly to participants’ experiences and to ascribe deeper meaning to their accounts.

Accordingly, we adhered to two established frameworks to support meaningful inclusion. We followed six of the seven AASPIRE guidelines for meaningful inclusion of autistic adults as co-researchers (Item 7 was not applicable due to the absence of dedicated funding; all participants contributed voluntarily) [30]. Consistent with this approach, and following the ELPART tool [36], which evaluates autistic participation across five research stages—(1) research topic, (2) methods and tools, (3 and 4) conducting and analyzing, and (5) dissemination—involvement in our study reached level 4 (the highest level achievable) across all stages.

3. Results

Based on the analysis of participants’ narratives, three main themes were developed, each with two subthemes. See Figure 1 for an overview of the themes and subthemes identified in the findings.

3.1. Theme 1: Ups and Downs: Navigating Emotional and Sensory Experiences

This theme describes the sensory experiences and potential emotional overload that mothers encountered during the first days with their baby. This period was characterized by heightened physical and emotional sensitivity, particularly related to physical contact, the baby’s crying, and the breastfeeding process.

3.1.1. Subtheme: Safety and Shelter

During the postpartum period, one of the earliest memories shared by both groups of mothers was a strong sense of protection that they likened to that of an animal. This reflects an instinctive and deeply rooted anthropological, mammalian response: to protect, nourish, and safeguard the newborn from potential external threats. This theme was discussed as follows:

“I saw myself as a total lioness; I didn’t want anyone to come near my child. I even remember lowering the blinds at home in case someone came by, thinking we weren’t there”.

(autistic mother 1, has three children)

Similarly, others recounted that “I wanted to be left alone with my baby, so no one would come to see us” (autistic mother 5, has one child) or “It’s mine, it’s mine, I was the one who gave birth to her” (autistic mother 2, has one child). This intense need to protect was also evident among non-autistic mothers, as in the following aspect:

“I see myself as very mammalian, I think it was a bit like survival mode. I let that protective part toward my child emerge fully, even more than towards myself. I remember the first weeks feeling like something very animalistic, like I needed to stay at home. Going out made me feel insecure, not wanting to interact with other people. It wasn’t very rational—there were certain people who, if they came close to me, I felt a lot of rejection, not because I had anything against them”.

(non-autistic mother 5, has one child)

3.1.2. Subtheme: Altered Sensory Processing

During the postpartum period, heightened sensory experiences were reported by all mothers, but they were especially pronounced in autistic mothers. As stated, most of the autistic mothers did not have a formal diagnosis at the time of giving birth; nevertheless, all were aware of their sensory challenges, as in the following response: “A baby is very intrusive […] they touch you constantly…” (autistic mother 4, has one child). Much of this sensory alteration reached a critical point during breastfeeding (five autistic mothers and five non-autistic mothers breastfed), a time when the mother’s body becomes a constant space of contact, demand, and stimulation, as in the following response: “At first, I thought I wouldn’t be able to do it because of hypersensitivity, mastitis, work… but we managed quite well [she was speaking about how they carried on breastfeeding for years]” (autistic mother 5, has one child). This overwhelming experience could reach critical moments, as detailed in the following response:

“I perceived breastfeeding as a moment of connection and tenderness, but most of the time nursing felt intrusive, and I had to make a great effort to endure without having a shutdown”.

(autistic mother 4, has one child)

Some even reported dissociation to be able to carry out breastfeeding, as follows:

“I have been disconnected from my body, I don’t know if it was to recover quickly from the wounds and to be able to breastfeed despite being touched constantly”.

(autistic mother 5, has one child)

At the same time, there was a lack of understanding from medical services about this sensory profile characteristic of autism, or, at minimum, a need to respect what the mother’s body was communicating, as in the following response: “When they put the baby to my breast, I was already tense, I felt bad” (autistic mother 3, has three children).

This moment can be very invasive for autistic mothers, especially when they are not asked or their bodily limits are not respected, nor is adapted information provided to their needs—even if a formal diagnosis has not yet been made. This is discussed as follows:

“It is very invasive, yes, and as I said, they don’t explain anything either […] It felt more like pressure to continue with that breastfeeding […] I liked feeling that bond I hadn’t experienced, I wanted to live it, but I wasn’t comfortable”.

(autistic mother 3, has three children)

Three non-autistic mothers also narrated difficulties in their breastfeeding experiences, though these were not related to sensory issues but rather to challenges, such as the baby’s sucking problems, as in the following extract:

“It wasn’t easy, but from 6 or 7 months, when the pain disappeared, it was super cool and still a very beautiful experience, with its ‘not so good’ things”.

(non-autistic mother 5, has one child)

3.1.3. Subtheme: Emotional Ambivalence

In the narratives, it is common to find the “ups and downs” (autistic mother 3, three children) of emotional experiences present in the postpartum period, i.e., the first days with their babies, because “at those moments you are either strong or you can collapse” (non-autistic mother 1, three children). Other mothers shared that “I felt anxious, lost, very misunderstood” (non-autistic mother 6, only child); “I was just as happy as the next day I didn’t want to get out of bed. Like, emotions were going up and down all the time” (autistic mother 1, three children); “They were like rollercoasters” (autistic mother 3, has three children).

Returning home from the hospital is a key moment that intensifies this process of change and restructuring, as in the following extract: “When I got home, it was like a flood of emotions, I started crying and was like… this is your home now too” (non-autistic mother 2, has one child). The first days, weeks, or months are moments filled with very ambivalent emotions, discussed as follows:

“…a lot of sadness, a strong sense of loss, but at the same time also a lot of happiness and a strong feeling of rebirth, of rediscovering myself, my own body, and accepting my new reality”.

(non-autistic mother 5, has one child)

3.2. Theme 2: Lack of Information and Support: The Root of Increased Vulnerability

The general lack of information about motherhood, expressed by all of the mothers in their accounts, is taken into consideration. This lack of support—especially from the medical team—directly impacts the emotional state of mothers during the postpartum period, potentially increasing their feelings of vulnerability and lack of control.

3.2.1. Subtheme: Insufficient Information and Guidance

Both autistic and non-autistic mothers frequently reported a lack of information and support during the periods before and after childbirth—times when women are especially vulnerable, and the quality of care received can significantly influence their postpartum experiences. For autistic women, staying informed serves as a crucial emotional self-regulation tool, providing anticipation for situations that provoke uncertainty. As one autistic mother shared in the following response:

“Much of the information I gathered about motherhood wasn’t useful because it didn’t take into account the difficulties faced by an autistic person, especially someone hypersensitive like me. I had to figure out on the fly what worked and what didn’t, which is extremely hard for me and consumes a lot of energy and resources”.

(autistic mother 4, has one child)

Autistic women faced a dual challenge, i.e., the general lack of information about autistic motherhood and the insufficient guidance provided by healthcare services, discussed as follows: “Healthcare professionals don’t support you, no, and they don’t give you information. […] There are all these procedures, but there’s a lack of empathy and a lot of work needed to be more humane” (autistic mother 1, has three children). Adding to this, another respondent stated that “It doesn’t seem right to complain, and if you’re autistic, even less so, because they don’t understand what being autistic is or why you complain” (autistic mother 6, has one child).

In contrast, when autistic mothers did feel supported, their experiences were completely different, with respondents stating that “The good thing is that I was informed about everything and could manage it” (autistic mother 6, has one child) and “The midwives helped me a lot; we could even contact them by video call from home” (autistic mother 5, has one child), demonstrating the importance of providing clear information and anticipation for an event that can trigger ambivalent emotions, such as the postpartum period, ultimately facilitating better coping and peace of mind.

Still, women in general “are uninformed when it comes to motherhood” (autistic mother 6, has one child). This lack of knowledge is even more pronounced in relation to breastfeeding, as in the following response: “No, I figured it out on my own and dealt with it alone” (non-autistic mother 2, has one child). Another mother added that “On one hand, yes, you do have some information, but on the other, when there’s any kind of problem, I honestly think even the professionals don’t fully know what to do” (non-autistic mother 5, has one child). Other examples are as given follows: “During this time of motherhood and in many aspects of professional support, I felt not only misunderstood, but also alone, unprotected” (non-autistic mother 6, has one child) or “They should explain more about what they’re doing—yes, they’re the professionals, but it’s also my body, my baby” (non-autistic mother 1, has three children). Ultimately, it is the mothers themselves who take on the responsibility to prepare, as in the following response: “In the end, we’re the ones who get ready, who seek out information, who read […] We carry the burden of doing right, doing wrong, and the guilt that follows. It’s very hard to mother alone (without support)” (non-autistic mother 6, has one child).

3.2.2. Subtheme: Autonomy and Solidarity: The Maternal Response to a Lack of Information

In response to the lack of information, many mothers implemented proactive strategies to help anticipate and reduce uncertainty, as in the following response:

“I read a lot, I read a lot […] And I even took an online midwifery course, where they covered topics like breastfeeding, early care, and maternal rest”.

(non-autistic mother 6, has one child)

Although social interaction can be particularly demanding or invasive for some autistic women—“[I find it difficult] the whole part that involves socializing, even if it’s minimal” (autistic mother 4, has one child)—several autistic mothers found in parenting a strong enough motivation to seek support from other mothers (especially autistic) or trusted individuals—a secondary strategy to compensate for the lack of information they felt was lacking in the system, thereby fostering an admirable sense of sisterhood, as in the following response:

“Find a mothers’ group. […] I’ve discovered that autistic women tend to want to help each other, share our experience and knowledge, support one another”.

(autistic mother 4, has one child)

Other autistic mothers also described the value of mutual support, particularly in relation to breastfeeding, as follows: “We created a breastfeeding support group. I felt very, very supported by the other women” (autistic mother 1, has three children), or “With support and help, I already had a friend who had breastfed. She came over and said: you have to do it like this, don’t get discouraged, it’s going to take time” (autistic mother 2, has one child).

In the case of non-autistic mothers, all tended to complement self-acquired knowledge with help from others, turning to support networks —such as family, other mothers, friends, or professionals— as reflected in expressions, like the following: “You find your books, your stories, like… my cousins who both breastfed, and my cousin’s wife” (non-autistic mother 2, has one child); “I had no support until I put together a network of mothers” (non-autistic mother 6, has one child); or “I felt very alone, and I went to a breastfeeding group my sister recommended. Hearing other moms in very similar situations helped me talk about my fears at that moment” (non-autistic mother 4, has one child).

In contrast, most autistic mothers sought information from books or online sources, rather than people, as in the following responses: “I looked for information in a very autistic way and prepared myself as best I could” (autistic mother 4, has one child); “I’ve read a lot, and I still do” (autistic mother 5, has one child).

Beyond seeking information and support, three of the mothers transformed their experiences into tools for helping others. One autistic mother developed her own birth guidelines, as discussed in the following response:

“I had to create my own birth guideline. Fortunately, my midwife and the entire maternity ward at the hospital were receptive and willing to adapt to my needs. […] We shouldn’t have to rely on luck to have our needs met”.

(autistic mother 4, has one child)

In doing so, she not only addressed her own needs but also took a first step toward advocating for specialized guidelines for autistic women in clinical settings.

Additionally, two non-autistic mothers decided to become breastfeeding counselors, supporting others on a more personal and intimate level, discussed as follows: “I’m a volunteer breastfeeding counselor with a maternal support organization” (non-autistic mother 4, has one child). As the second mother pointed out, it’s not just a matter of luck, but of access to information, noting that “I was lucky everything went well, but many aren’t, and there’s still a lot of missing information” (non-autistic mother 2, only child). This kind of direct contact aligns with broader access to resources, even on a voluntary basis through associations, since “some people can’t afford to buy books or don’t have time to read. There’s a real lack of access to updated information” (non-autistic mother 2, has one child).

Ultimately, the activism and solidarity among mothers are powerful—together, they form a valuable support network and sisterhood.

3.3. Theme 3: The Social Dimensions of Early Postpartum: Tensions and Expectations

This section addresses the pressure mothers experience due to external perceptions and the social stigmas surrounding motherhood, particularly during the early years, including the postpartum period. When these societal expectations are reinforced by those closest to them, women may experience feelings of guilt or self-imposed demands, often leading to internal conflict with their own needs or natural rhythms.

3.3.1. Subtheme: Family Visits in the Postpartum Period: Emotional Support or Source of Distress?

Autistic mothers appeared to report more often than non-autistic mothers that they perceived family visits as intrusive during a time when they did not need or want company. This is particularly important, as the family constitutes the closest support network and could otherwise provide the greatest help during the first months. One autistic mother, reflecting on visits, stated that “Oh no… they handled that very poorly, I always felt very uncomfortable” (autistic mother 3, has three children), while another noted a clear preference for solitude with her baby, as follows: “I did have some support, although what I really wanted was to be left alone with my baby, for no one to come visit us” (autistic mother 5, has one child). She added that, although families often intend to help, “they often don’t know how, and they don’t want to change” (autistic mother 5, has one child). For autistic mothers, these expectations can be particularly overwhelming, as they are not only confronted with normative gender mandates around motherhood—as expressed by one mother—“You have to smile, but no one [in the family] really pays attention to you. I often felt like I had to be there just because I was the one who had given birth, but then I wasn’t really wanted” (autistic mother 4, has one child)—but also with the “lack of understanding and empathy from others regarding your difficulties and needs. The most ironic and frustrating part is that you, as an autistic person, are the one with the difficulties, and yet you are the one expected to adapt to everyone else” (autistic mother 4, has one child). This lack of understanding was already apparent in the earliest moments postpartum, with one mother stating that “It took a big argument with my parents for me to be able to decide that I didn’t want visitors at the hospital after giving birth” (autistic mother 6, has one child).

In contrast, non-autistic mothers often perceived family visits in the early days, weeks, or months after birth as supportive, providing emotional comfort, companionship, and a sense of security. As one stated, “In those specific moments when I do need help, I’m lucky that I can sort it out with just one call” (non-autistic mother 1, has three children). Another highlighted the significance of connecting with other mothers, stating that “I felt very supported […] For me, it was like meeting people […] who were a lifeline for me during breastfeeding […] They were anchors in my experience of motherhood” (non-autistic mother 5, has one child), while another stated that “I had several months of calm and I was not alone […] I’ve felt supported the entire time” (non-autistic mother 2, has one child).

These accounts reveal a significant difference in how family visits are experienced postpartum. For autistic mothers, family expectations to do things in a certain way can feel “incompatible with being autistic” (autistic mother 4, has one child). These expectations operate unevenly, as autistic mothers face sensory, communicative, and relational barriers that are often misunderstood by their family environments. “They didn’t understand—even when I was able to verbalize it, which wasn’t always the case—that I needed to reduce sensory and social stimulation as much as possible just to cope with the demands I placed on myself to breastfeed” (autistic mother 4, has one child). It is essential that families accept and respect these boundaries. “My husband had to set boundaries” (autistic mother 3, has three children); “It made me angry, I was so angry […] I’m sorry, I just can’t help it. I don’t want anyone coming over” (autistic mother 1, three children). Mothers in the postpartum period are in a vulnerable state, facing constant changes and notable emotional ambivalence. Added tensions, such as these, can intensify distress, making it all the more necessary to respect and accommodate their needs.

3.3.2. Subtheme: Haste, Pressure, and Judged Motherhood According to Society’s Expectations

Motherhood has long been shaped by a socially constructed ideal of the “good mother—one who is also expected to be a good partner, good daughter, good friend, good worker, good cook, and so on. On top of that, you always have to be fine, get your pre-pregnancy body back, and meet a thousand other expectations” (autistic mother 5, has one child). These demands are often imposed urgently and without regard for the physical, emotional, and psychological processes that define the postpartum period. Constant judgment becomes a daily reality for women, especially after they become mothers.

For autistic mothers, this pressure may be experienced with heightened intensity, as illustrated in the following account:

“Simply being an autistic mother—just by being a mother, it feels like you lose your right to privacy, to have time for yourself, to meet your own needs, etc. For an autistic mother, this is terrible. How are we supposed to manage a situation or even a single day if we don’t have time to self-regulate? How can we handle social interaction if we don’t have time to prepare?”.

(autistic mother 4, has one child)

This testimony highlights how motherhood, when intersecting with autism, can intensify external pressures and be further complicated by a lack of understanding of how autism manifests in women. However, this experience of being judged was not unique to autistic mothers—both autistic and non-autistic mothers expressed feeling scrutinized in their maternal choices, as in the following responses: “I often felt judged […] you always worry a little about how others will judge you. Overall, people speak from ignorance—many don’t know what’s behind a mother’s decisions” (non-autistic mother 1, has three children); “It’s hard not to let the comments or looks get to you…” (autistic mother 5, has one child). This attitude is also displayed in the following response:

“I thought people would respect my needs. But not being able to follow those standards turned into an endless source of problems […] I feel annoyed, frustrated, and anxious every time I have to deal with that kind of person”.

(autistic mother 4, has one child)

As this last account reveals, social judgment often stems from a lack of understanding or empathy. As another participant noted “judgment is inherent to people” (autistic mother 6, has one child). This was echoed by a non-autistic mother, who stated the following:

“Everyone had an opinion—even if I didn’t ask for it. I decided to stop listening to most of it and go with my instincts. I felt much more confident”.

(non-autistic mother 3, has three children)

Mothers also noted how society imposes a sense of urgency and rush, as in the following response:

“There’s a lot of pressure on mothers […] It’s like, ‘OK, you’re a mom, congratulations’, but two months later, everyone expects you to act as if you’re not”.

(non-autistic mother 5, has one child)

Altogether, these narratives reveal how social expectations place a heavy burden on mothers, intensifying their sense of self-demand and leading to emotional strain. It is not an internalized personal pressure, but a systemic societal norm embedded in the concept of motherhood itself. This external pressure can make an already vulnerable period even more challenging, as discussed in the following response:

“Most of the difficulties, the hardest and worst parts, came from outside […] society as a whole made my experience of motherhood infinitely more difficult and traumatic than it could have been”.

(autistic mother 4, has one child)

Ultimately, what these mothers ask for is simple and fundamental, namely “To not be burdened by expectations—neither from society nor from ourselves” (autistic mother 5, has one child).

4. Discussion

This paper aims to highlight and analyze the narratives of autistic and non-autistic Spanish mothers during the immediate postpartum period and after two years. The results reveal a complex experience, full of emotional ups and downs, lack of information and support, and social challenges beyond their control. Focusing the analysis on the immediate postpartum period—a stage as significant as it is vulnerable—revealed critical aspects of the care mothers and birthing parents receive, especially in terms of meeting their individual needs. The narrations show that the care provided during this period follows a generalized model that does not take these particularities into account, which is even more problematic in the case of autistic mothers and birthing parents. For them, this already challenging period is intensified by the lack of adapted sensory, emotional, and social support. It should be highlighted that, alongside these challenges, the autistic mothers in this study were diagnosed late, with consequent individual and social implications.

Theme 1 emphasizes these experiences, which are marked by a significantly altered sensory perception and emotional ambivalence described as “ups and downs”. Particularly in the case of autistic mothers, a more intense sensory description is observed, triggering intensified responses to sensory stimuli (e.g., lights, sounds, smells, touch) [8]. This sensitivity to noise, light, texture, or social stimuli has been widely documented in the literature on autism [37,38]. All of this can amplify stress and overload in the early postpartum period [8]. Some autistic mothers and birthing parents described breastfeeding as a very intrusive experience for them. When they decide to breastfeed, autistic mothers and birthing parents are exposed to sensory challenges, such as being “touched” and pain [26]. These sensory challenges, which can be overwhelming, include various aspects, such as the baby’s touch, sounds and crying, among others. In turn, autistic mothers and birthing parents also experience intrusion from healthcare professionals, for example, being touched by healthcare professionals was distressing and expressed the need to be asked before being touched [26]. Despite these limitations, the autistic mothers in the present study all chose to breastfeed, some for less time than others due to their high sensory load, but all of them wanted to experience the bond that develops between mother and child. For this reason, there is an urgent need for maternity and infant feeding services to better accommodate the needs of autistic mothers and birthing people, through adjustments in service design and comprehensive staff training—even when challenges are present, regardless of whether or not a formal diagnosis exists [9,26].

From an emotional perspective, both autistic and non-autistic mothers expressed ambivalence, with feelings of joy coexisting with sadness and a sense of loss. While this “roller coaster” is common among many women during the postpartum period, it may be more intense for autistic women due to greater difficulties in regulating emotions in highly demanding and socially normative contexts [11]. Furthermore, these mothers often experience a lack of understanding from their immediate environment and medical staff regarding their emotional states, which can lead to a sense of mismatch [21]. Feeling neither understood nor acknowledged may also make it more difficult for them to ask for help and can contribute to a greater risk of mood disorders during the postpartum period, especially in the absence of a support network [11].

These narratives concerning altered sensory experiences and emotional ambivalence are intensified or mitigated depending on the level of preparation, information, and support received. This is reflected in Theme 2, which shows how both groups of mothers reported a significant lack of support and information from healthcare services, leading to increased feelings of insecurity and isolation during the postpartum period. This informational gap aligns with previous studies reporting that the provision of information is often fragmented, contradictory, or poorly adapted to women’s needs [9]. For autistic mothers and birthing parents, this gap is even more pronounced. Research shows that anticipation and clear communication are essential for autistic women to navigate major life changes with greater confidence and reduced anxiety [39,40,41,42]. Autistic mothers and birthing parents face a dual challenge, due to a lack of scientific literature addressing motherhood/parenthood from an autistic perspective and insufficient training among medical professionals to support them appropriately. The current absence of guidelines specifically designed for autistic women—in postpartum care or other areas—creates an informational void that impedes proper preparation [9,11,39]. It is, therefore, urgent for healthcare services to be better informed and organized to serve autistic mothers and birthing parents, and for healthcare professionals to understand autistic differences, including sensory processing difficulties, variations in pain perception, communication differences, and alternative help-seeking behaviors [3,26,41,42]. As provided in the SPACE framework, five core autistic needs in healthcare can be identified, namely Sensory Needs, Predictability, Acceptance, Communication, and Empathy [41].

In response to the lack of information and support, both autistic and non-autistic mothers sought out their own resources to reduce uncertainty and address their individual needs. Both groups supplemented the information gathered from books or training courses by turning to mother groups, family members, or qualified professionals. While support groups can be beneficial for both groups, they take on added significance for autistic mothers and birthing parents, as they offer a safe space to share experiences and stories, as well as provide mutual support and recommendations [1]. Although autistic mothers and birthing parents used these social spaces, they showed preference for individual strategies. For example, one autistic mother created birth guidelines adapted to her autistic needs. This planning reflects a characteristic cognitive style centered on organization and written structure—a strength that can benefit any mother by fostering clarity and preparedness [9]. In contrast, two non-autistic mothers became lactation consultants, offering direct support to other mothers and birthing parents. This contrast highlights how similar challenges lead to different responses, with one being more structured, involving written guidelines for reaching other autistic mothers, and the other being more interpersonal, involving one-on-one support. Both examples convey the same message, namely mothers supporting mothers in times of vulnerability, transitioning from isolation to a sense of sisterhood, and collective empowerment [1].

Additionally, as explored in Theme 3, motherhood often exposes women and birthing people to constant social judgment, particularly from their own families, ranging from ignorance to blame—this judgment tends to be compounded when the mothers are autistic and, as in this case, also received a late diagnosis [43]. All mothers reported feeling both pressured and judged to meet socially imposed expectations around motherhood. Failing to meet these expectations frequently provokes guilt, shame, or fear of external judgment [19,43]. These results emphasize how autistic mothers/birthing parents, due to widespread misunderstanding of autism and their specific characteristics and needs, often feel misunderstood by both their close circles and healthcare providers. They expressed feeling obliged to adapt socially in environments that fail to accommodate them, effectively forcing them to “mask” in order to avoid judgment [1]. The experiences of autistic mothers and birthing parents are marked by a high incidence of negative interactions rooted in misunderstanding [11]. They find it difficult to access appropriate help and often fear being judged as inadequate mothers and birthing parents [12]. Moreover, as Bargiela et al. (2016) highlight, autistic women (and birthing people) often mask their difficulties to meet social expectations, which can be emotionally and mentally exhausting [2,44]. In this regard, the present study underscores the importance of setting boundaries with close contacts who do not respect autistic mothers’ decisions. As Leedham et al. (2020) suggest, increased autism awareness among both healthcare professionals and immediate social circles can significantly improve the postpartum wellbeing of any mother or birthing parent [45].

One particularly strong theme emerging from the analysis is the ambivalence surrounding postpartum family visits, which can serve as either emotional support or a source of distress. For non-autistic mothers, these visits were interpreted as a vital and comforting support network—described as a “lifeline”. However, for autistic mothers, these could represent an additional burden. Support based on non-autistic norms proves ineffective when the specific needs of autistic women are not acknowledged [1]. In the Spanish context, these dynamics are further shaped by the strong involvement of the extended family, where postpartum visits are often regarded as a cultural expectation and a sign of support. While this can provide comfort for some mothers and birthing parents, it can also intensify feelings of intrusion for autistic women and birthing people, who may require more controlled and predictable environments.

This study has some limitations that should be considered. The relatively small sample size limits the generalizability of the findings to broader populations. Additionally, the self-selecting nature of participants, particularly mothers willing to share their experiences, may introduce bias toward those with more pronounced challenges or stronger advocacy voices. It should also be noted that our participants constitute a specific subset of autistic women—diagnosed later in life—and, thus, the findings may not be representative of all autistic mothers or birthing people. The reliance on retrospective accounts may also be affected by recall bias. Future research would benefit from longitudinal designs and more diverse samples, including greater representation across socioeconomic, cultural, and geographical backgrounds, to deepen understanding of postpartum experiences among autistic and non-autistic mothers and birthing parents.

5. Conclusions

In conclusion, several key aspects of this study merit attention. First, it represents one of the few investigations addressing autistic motherhood in the Spanish context [1,3,43,46,47]. More specifically, it constitutes the first comparative study in Spain between autistic and non-autistic mothers, focusing on the immediate postpartum period and two years thereafter. Based on the experiences collected, this study calls for healthcare professionals to receive training and develop a deeper understanding of autism in women [11,29], in order to provide respectful, adequate, and needs-based support [41]. Likewise, it is essential to develop tailored guidelines that address the specific sensory, communicative, and social characteristics of autistic mothers and birthing parents, respecting their pace, boundaries, and parenting styles—particularly during such a vulnerable stage as the postpartum period.