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  • Writer's pictureZoltan Mende

Neurodiversity Celebration Week Guest Blog Series

by Sarah Honeywood.



Hi all, my name is Sarah and alongside being an autistic parent to two beautiful

boys, I am also a midwife in the National Health Service.


I had always had a special interest in pregnancy and birth, so midwifery seemed the

logical career path for me. When I was diagnosed, aged seventeen, the psychologist

had told me that I would struggle to maintain relationships and would be unlikely to

hold down a job so naturally I was terrified that I would never make it through the

training, let alone stay employed. My training was a very steep learning curve. Not

only was I studying the same detailed curriculum as my classmates, but I was also

learning skills that they all took for granted: reading facial expressions, understanding non-verbal cues and being able to cope with the overwhelming stimuli

of working in a patient-facing setting. These are all fairly essential skills in the world

of midwifery as quite often we see people at their most vulnerable and they may not

be able to clearly communicate their wishes or needs. It took long nights of being

holed up in the university library and many, many social blunders to even come close

to passing for neurotypical (though to this day my facade does not hold up under

scrutiny). Against all odds, I succeeded and qualified with first class honours.

I have often been asked if I feel like I'm at a disadvantage in my role. In some ways I

suppose I am. Whilst other midwives can easily make conversation and instantly

build rapport with families, I find it hard to know what to say beyond my rehearsed list

of small talk topics (though these still come in very handy). My colleagues are often

good at 'reading between the lines' and picking up on subtleties that I can't see.


They also don't have to put up with the sensory overload caused by the lights,

sounds and smells of hospitals and people's homes. To some extent, this does have

an impact on my functioning as a midwife as it means that I have to put a lot more

effort into things that my colleagues take for granted, but I wouldn't have said that its

effect is completely negative. As is common with a lot of us neurodivergent folk, it's

not necessarily that we can't do it at all, it's just that it takes up a lot more energy and

concentration to do so. It has taken years but I do now have strategies that I can

implement at work that don’t impact my duties, such as, after a two hour long

booking appointment taking myself off for five minutes of total silence and allowing

myself to “recharge” slightly before moving on to the next task.


Conversely, I feel that I also benefit from being autistic. Thanks to my logical thought

processes and information recall, I am able to memorise and recite mountains of

hospital guidelines and research. I also quickly discovered that, to no one’s surprise,

I had an affinity for neurodivergent service users. Things that my colleagues couldn't

understand were second nature to me. Reducing physical contact and arranging a

room so that eye contact isn’t forced are instinctual as I know that they are things

that help me in new environments. When obtaining consent for a procedure I also

take special care to describe the full process and what sensations, sounds or smells

may be experienced as I know that these seemingly small details can have a huge

impact. When discussing birth preferences, I book a double appointment so that

there is less of a time pressure and start by asking about any particular aversions or

sensory needs so that these can be addressed early and documented for the

midwife that will provide labour care if I can’t be there.


As an autistic midwife and a woman who has been through the "system" twice, I feel

uniquely placed to help other neurodivergent service users. I have been wracking my

brain for a short list of suggestions for navigating the perinatal period, but due to the

wide variety of experiences it's very difficult to offer blanket advice. My biggest "tip" is

to arrange an appointment with your midwife to discuss at length your specific

needs. It's also a good idea to have a comprehensive birth preferences document,

listing your own sensory needs so that whoever looks after you in labour or

afterwards knows how best to support you. For example, in my own birth plan I wrote

'I am autistic and often suffer from sensory overload, particularly when touched so

please do not touch me during contractions unless requested. When I'm in pain I like

to focus and not talk. I am happy for intermittent auscultation and maternal obs to be

performed without my consent being gained each time'. I used similar phrases for

2nd and 3rd stage of labour and the postnatal period.


Being an autistic person in the birthing world certainly has its challenges. Having

qualified five years before having my first baby and supporting numerous

neurodivergent women over those years I had a decent idea of what to expect in

terms of pregnancy, birth and the postnatal period. But I don't think that anything can

truly prepare you. Antenatally, I planned for almost every eventuality which was

made easier by having 'inside knowledge' of the system and the hospital that I

birthed at. Despite all of this, I still ended up having a traumatic birth (failed

ventouse, followed by an emergency caesarean). Of everything I had prepared for I

hadn't accounted for how I would cope with the total loss of control.


The early days with my son were not easy either. He struggled to feed and to sleep

and I pushed my trauma as far down as I could. I was, after all, a midwife and had

seen others go through much, much worse. I should be able to cope, right?

Unfortunately, this dangerous way of thinking caused my mental health to spiral and

to cut a long story short I ended up being admitted to a mother and baby psychiatric

unit.


After a long recovery, we found out that we were expecting our second son. This

time our high-risk pregnancy ended in a smooth, quick and empowering birth. A

totally contrasting experience. I noticed immediately how different I felt without the

black cloud of trauma hanging over me. I truly enjoyed my baby and despite similar

feeding difficulties I coped much better and my mental health remained stable. Even

having a 21 month old toddler to deal with too didn't seem as much of a struggle as I

had thought it would be and we were soon bumbling along like we'd always been a

family of 4! For the first time I realised how truly traumatised I had been the first time

around. I hadn't noticed how impaired my cognitive function was or how it had

impacted the bond that I had with my eldest son in the early months. What helped a

lot with this bonding work was rediscovering babywearing. We had fallen out of the

habit first time around after spending time in the mother and baby unit, but this time I

made a conscious effort to carry one or both of my boys daily. I had worried about

the sensory impact of having a wriggling baby attached to me but discovered that the

weight and pressure was actually very comforting. I found a deep love for wrapping

my boys and qualified as a babywearing consultant when my baby was 5 months old

and now run my own consultancy practice.


I feel very fortunate to not only be working in a field that allows me to help others go

through, and in some instances avoid, what I’ve been through as an autistic pregnant

woman and mother, but to also be in a position to share my experiences. Whether

these experiences have been good or bad are almost irrelevant to me at this point.

They have taught me a great deal and I feel that they have shaped who I am now as

a parent and as a midwife. Like I said, being an autistic person in the birthing world is

by no means easy but I feel that the reward by far outweighs the risk. Finding a

community that can offer support, whether in person or online, can also make a huge

difference. Hopefully with more of us sharing our stories, we can increase

understanding amongst healthcare professionals and even our own families.


Understanding leads to implementation and implementation leads to improvement!

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