{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:03:55Z","timestamp":1785243835605,"version":"3.55.0"},"reference-count":29,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR Doctoral Clinical and Practitioner Academic Fellowship","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"The Health Foundation\u2019s Grant","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","award":["NIHR203312"],"award-info":[{"award-number":["NIHR203312"]}],"id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,17]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Maternity care in the UK is under increasing scrutiny, with reports indicating that services often fail to meet the diverse needs of women and birthing people. Autism spectrum disorder is a neurodevelopmental condition involving persistent difficulties in social communication and interaction alongside restricted and repetitive behaviours. Autistic women and birthing people may face distinct barriers to accessing and navigating maternity care, compounded by limited awareness and inflexible service provision. To improve care responsiveness, it is essential to understand both the challenges faced by autistic women and birthing people and those encountered by healthcare professionals in delivering optimal care. This scoping review aims to identify and map existing literature and evidence on maternity care in the UK for autistic women and birthing people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search, restricted to January 2000 to July 2026, will be conducted across multiple databases, including the Cumulative Index of Nursing and Allied Health Literature, PubMed\/MEDLINE, Embase and the Overton Index. Reference lists of included studies will be screened to identify additional relevant literature. Extracted data will include study context, research focus and key findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Analysis<\/jats:title>\n                    <jats:p>The literature will be mapped across several domains: experiences of care among autistic women and birthing people; maternity care providers\u2019 knowledge of autism and ability to provide optimal care for autistic women and birthing people; interventions designed to support this population and relevant government policies influencing practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>As this review involves secondary analysis of published literature, ethical approval is not required. Findings will be presented using tabular and diagrammatic formats, supported by narrative synthesis. Results will be disseminated through publication in a peer-reviewed journal and via relevant professional networks and charity partners, and may inform future research, policy and practice in maternity care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114558","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:20:25Z","timestamp":1785241225000},"page":"e114558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding maternity care provision and experience for autistic women and birthing people and their care providers in the UK: protocol for a scoping review"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4126-7898","authenticated-orcid":false,"given":"Joanne","family":"Welsh","sequence":"first","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Redmond","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"McPeake","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik","family":"Nikoli\u0107","sequence":"additional","affiliation":[{"name":"Clinical Neuroscience Department, Brighton & Sussex Medical School, University of Sussex, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-0938","authenticated-orcid":false,"given":"Ann-Beth","family":"Moller","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072805200935000_16.7.e114558.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.cpnec.2022.100138","article-title":"Birth, love, and fear: Physiological networks from pregnancy to parenthood","volume":"11","author":"Grant","year":"2022","journal-title":"Compr Psychoneuroendocrinol"},{"key":"2026072805200935000_16.7.e114558.2","doi-asserted-by":"crossref","unstructured":"O\u2019Reilly E , Buchanan K , Bayes S . Emotional safety in maternity care: An evolutionary concept analysis. Midwifery 2025;140. doi:10.1016\/j.midw.2024.104220","DOI":"10.1016\/j.midw.2024.104220"},{"key":"2026072805200935000_16.7.e114558.3","unstructured":"Kirkup B . The report of the morecambe bay investigation. London The Stationery Office; 2015."},{"key":"2026072805200935000_16.7.e114558.4","unstructured":"Independent Maternity Review . Ockenden Report \u2013 Final: Findings, Conclusions, and Essential Actions from the Independent Review of Maternity Services at the Shrewsbury and Telford Hospital NHS Trust. London: Crown, 2022."},{"key":"2026072805200935000_16.7.e114558.5","unstructured":"Kirkup B . Reading the Signals: Maternity and Neonatal Services in East Kent \u2013 the Report of the Independent Investigation. London: Crown, 2022."},{"key":"2026072805200935000_16.7.e114558.6","unstructured":"All-Party Parliamentary Group on Birth Trauma . Listen to mums: ending the postcode lottery on perinatal care. United Kingdom, 2024."},{"key":"2026072805200935000_16.7.e114558.7","unstructured":"Felker A , Patel R , Kotnis R , et al . Saving Lives, Improving Mothers\u2019 Care: Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2021-23. Oxford: National Perinatal Epidemiology Unit, 2025."},{"key":"2026072805200935000_16.7.e114558.8","unstructured":"World Health Organization . International classification of diseases 11th revision (icd-11) Geneva. Available: https:\/\/icd.who.int\/en [Accessed 03 Oct 2025]."},{"key":"2026072805200935000_16.7.e114558.9","unstructured":"National Autistic Society . What is autism? London, 2025. Available: https:\/\/www.autism.org.uk\/advice-and-guidance\/what-is-autism [accessed 03 Sep 2025]"},{"key":"2026072805200935000_16.7.e114558.10","article-title":"Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis","volume":"9","author":"McCrossin","year":"2022","journal-title":"Children (Basel)"},{"key":"2026072805200935000_16.7.e114558.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.yhbeh.2007.02.001"},{"key":"2026072805200935000_16.7.e114558.12","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1177\/13623613211022091","article-title":"Medical symptoms and conditions in autistic women","volume":"26","author":"Simantov","year":"2022","journal-title":"Autism"},{"key":"2026072805200935000_16.7.e114558.13","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S2215-0366(19)30289-5","article-title":"Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis","volume":"6","author":"Lai","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"2026072805200935000_16.7.e114558.14","doi-asserted-by":"crossref","first-page":"101759","DOI":"10.1016\/j.rasd.2021.101759","article-title":"Prevalence of attention-deficit\/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis","volume":"83","author":"Rong","year":"2021","journal-title":"Res Autism Spectr Disord"},{"key":"2026072805200935000_16.7.e114558.15","doi-asserted-by":"crossref","unstructured":"Westgate V , Sewell O , Caramaschi D , et al . Autistic Women\u2019s Experiences of the Perinatal Period: A Systematic Mixed Methods Review. Rev J Autism Dev Disord 2024. doi:10.1007\/s40489-024-00461-2","DOI":"10.1007\/s40489-024-00461-2"},{"key":"2026072805200935000_16.7.e114558.16","unstructured":"Fox D . Exploring how health inequalities can be addressed through autism training and understanding in maternity services. 2022."},{"key":"2026072805200935000_16.7.e114558.17","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1177\/13623613241274518","article-title":"Understanding the experiences of receiving and providing maternity care for autistic adults: A Multi-perspectival Interpretative Phenomenological Analysis study","volume":"29","author":"Moore","year":"2025","journal-title":"Autism"},{"key":"2026072805200935000_16.7.e114558.18","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00404-021-06109-4","article-title":"Sensory challenges experienced by autistic women during pregnancy and childbirth: a systematic review","volume":"305","author":"Samuel","year":"2022","journal-title":"Arch Gynecol Obstet"},{"key":"2026072805200935000_16.7.e114558.19","doi-asserted-by":"publisher","DOI":"10.1177\/1362361315576221"},{"key":"2026072805200935000_16.7.e114558.20","unstructured":"King S . How Do Maternity Services Support Autistic Women and Birthing People Now? What Improvements Could Be Made to Help Autistic People Who Are Pregnant and Giving Birth and the Staff Who Support Them?. 32.2023."},{"key":"2026072805200935000_16.7.e114558.21","doi-asserted-by":"publisher","DOI":"10.1177\/1362361319882227"},{"key":"2026072805200935000_16.7.e114558.22","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.2147\/CLEP.S176910","article-title":"Pregnancy outcomes in women with autism: a nationwide population-based cohort study","volume":"10","author":"Sundelin","year":"2018","journal-title":"Clin Epidemiol"},{"key":"2026072805200935000_16.7.e114558.23","doi-asserted-by":"publisher","DOI":"10.1111\/jan.14743"},{"key":"2026072805200935000_16.7.e114558.24","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-20-00167"},{"key":"2026072805200935000_16.7.e114558.25","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"2026072805200935000_16.7.e114558.26","unstructured":"United Nations Population Fund . State of the world\u2019s midwifery 2021 (SoWMy 2021). New York, United States of America, 2021."},{"key":"2026072805200935000_16.7.e114558.27","doi-asserted-by":"crossref","DOI":"10.1001\/jamahealthforum.2022.5541","article-title":"Maternity Care Deserts in the US","volume":"4","author":"Sonenberg","year":"2023","journal-title":"JAMA Health Forum"},{"key":"2026072805200935000_16.7.e114558.28","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.102093","article-title":"Improving outcomes for First Nations mothers and babies in Australia through culturally safe continuity of midwifery care: the time for scale-up is now!","volume":"61","author":"McLachlan","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026072805200935000_16.7.e114558.29","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-114558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:20:32Z","timestamp":1785241232000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-114558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,28]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-114558"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-114558","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}