Updated: Jan 31
The first 12 weeks of pregnancy (counting from the first day of the last menstrual cycle) is called the first-trimester. It is most often the time when the pregnancy is discovered. Many people experience a wide range of physical and emotional changes.
Some Autistic people may find the first trimester be more challenging, especially if they experience heightened interoception. Some steps you could consider either before conception or in early pregnancy:
1. Letting people know you’re pregnant
If possible in your situation, being open about the pregnancy from very early on may lead to greater access to support and understanding. If people don’t know that you’re pregnant it can take extra spoons to deflect questions or negativity.
2. Forget about the mainstream narrative, reflect on what works for you
Exhaustion and nausea is often the most noticeable physical change for all in the first trimester. Mainstream remedies for nausea and sickness, such as ginger, can carry an extra sensory challenge for some Autistic people. It is important to think about what works for you. What have you done in the past that works well when you’ve been nauseous? Some Autistic parents have shared what they have found useful, this is not an exhaustive list but maybe a good place to start as you learn more about your needs at this time in your life:
lots of small meals
starting the day with some dry crackers
sucking hard sweets
3. Conserving spoons and accessing support
As your spoons deplete what areas of life are easier to let go or loosen on? Who could support you? Are you in a position to pay for external support such as a cleaner?
4. Coping (accepting?) with physical change
If you have reduced interoception you may find yourself feeling irritable or exhausted. Your body requires more food and drink to support the pregnancy if that need isn't met your body may display signs of stress. It might be useful to consider ways to support yourself as early as possible. Some Autistic parents have found it useful to set alarms to remind themselves to drink and eat. I found filling a 2 litre bottle of water at the start of the day and aiming to drink it all by a certain time really useful. Friends have mentioned to me that they have been well supported by others bringing pre-prepare meals.
If you experience heightened interoception you may be very aware of changes within your body such as swelling of the breasts or changes in your digestive system. You may also feel the baby move very early in your pregnancy. Some people find these sensations exciting and welcome while others may be distressed by them. You may find that reducing other sensory input eases the overall sensation. Some people find it helpful to reduce other sensory input with loose clothes, noise cancelling headphones or more time alone. Is there someone who can listen as you share your experience? Can you make some time to get to know your new and changing body?
The first trimester (or before) can be a good time for research around what options are available in pregnancy, birth and parenthood. Many Autistic people (myself included) find extensive research can ease anxiety and satisfy curiosity.
Birth - early consideration of birth can be very useful. Learning about the process and what you can do to support yourself is very useful. Taking time to consider your own individual needs and ways of maintaining calm is really valuable, please check out our article on birth.
Birth rights - many Autistic parents have shared with us that they wished they had known more about their rights in pregnancy and birth, and felt more able to question decisions they didn’t feel they were a part of. Knowing this early on can lead to improved outcomes (Renfrew et al 2014). Read our article on birth rights to learn more.
Relationships with health-care professionals - Many Autistic people may find interactions with Health-care Professionals (HcPs) difficult. Pregnancy can be quite overwhelming with the amount of contact expected with HCPs. Our article on relationships with HCPs may be a useful read.
Transitions to parenthood - as well as being physically overwhelming, becoming a parent can be psychologically overwhelming too. Read our article on transition to parenthood for an Autistic perspective on becoming a parent.
Navigating information - there is vast amount of information available on pregnancy, birth and parenthood which can be very overwhelming, we have written an article on navigating information which we hope will make things a little easier.
Good support during the first-trimester of pregnancy is so important to your physical and mental health (Renfrew et al, 2014). If you feel that you are lacking support from people that really have an understanding of your experience you are welcome to join the peer support project at APUK. See our peer support Facebook group for more information or contact us here.