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1. Introduction
Autism spectrum disorder (ASC) is a heterogeneous neurodevelopmental disorder characterised by deficits in social communication and repetitive sensory behaviours, existing on a spectrum from mild to severe (Lord et al., 2018). Up to 70% of people with ASC have co-occurring mental health conditions (Simonoff et al., 2008). The estimated prevalence of ASC in the UK is 1.1%, with a male to female ratio between 3:1 and 5:1 (NICE, 2012). However, more modern research suggests this sex ratio is exaggerated (Green et al., 2019). Females often present differently compared to male counterparts, being better able to “camouflage” their symptoms and mimic others in social interactions (Green et al., 2019). Compared to the wealth of research surrounding ASC in childhood, the experiences of mothers with ASC during the perinatal period are overlooked. This is pertinent as mothers with ASC experience unique challenges during this period requiring different or more accessible care. Research by Rogers et al. (2017) identified three key contributors to perinatal issues for women with ASC: communication and service difficulties, sensory stress and parenting challenges. They recommend health-care workers are aware of these patients’ specific needs and better management of the sensory environment care is provided in. Furthermore, midwives report being inadequately prepared and unsupported when caring for those with ASC, highlighting a need for more training and attention given to caring for women with ASC during the perinatal period. Unfortunately, adult waiting lists for ASC assessment are extensive across the UK. While data regarding the average wait times for much of the UK is lacking, in Scotland there was an average waiting period of 331 days in 2014 (British Medical Association, 2019). Furthermore, many local services do not provide a target waiting period for assessment. This is particularly concerning as many mothers may go through pregnancy, birth and early motherhood on a waiting list for ASC diagnosis, and thus are likely to miss out on ASC-specific support services during this challenging period.
The NHS Long Term Plan and the Five Year Forward View for Mental Health (NHS Long Term Plan, 2019; Mental Health Dashboard, 2023) have provided significant investment to improve the quality and accessibility of community Perinatal Mental Health Services nationally (services which provide specialist care for women...