Birth Plan for Neurodivergent People – Tips from an AuDHD Midwife

Most birth plans focus on things like pain relief options, monitoring preferences, preferred positions during delivery, and whether or not you want delayed cord clamping. But if you’re autistic, ADHD, or otherwise neurodivergent, there’s a huge important part being left out: what helps your brain and nervous system feel safe, regulated, and respected. This part is extremely important in a birth plan for neurodivergent people, not only to make you feel safe and comfortable during labor but also for the progress and outcome of your birth.

As an AuDHD (autistic and ADHD) person myself and a midwife, I know how overwhelming and overstimulating labor and hospital environments can be. Bright lights, small talk, being touched without warning, or having to explain yourself while in pain—it can all add up fast and cause an overstimulated nervous system and shut down.

This post is here to help you build a birth plan that goes beyond the basics. One that includes your sensory needs, communication preferences, emotional support, and what really helps you feel calm and in control.

Why a Birth Plan for Neurodivergent People Needs to Be Different than for Neurotypicals

For many neurodivergent people, labor isn’t just physically intense—it can be completely overwhelming  emotionally and sensorily. Hospital environments are often full of unexpected noise, fluorescent lighting, unfamiliar people, and rushed communication. And while that might feel like a small inconvenience for some, it can be completely dysregulating for someone with sensory sensitivities or executive functioning difficulties.

Unfortunately, most standard birth plans don’t include sections for “please don’t make small talk during contractions” or “I need dim lighting and quiet to stay grounded.” But those things matter just as much—maybe even more—for someone who processes the world differently.

Neurodivergents need a birth environment that allows you to stay present without being overwhelmed. That’s exactly what a neurodivergent-friendly birth plan can help you create.

When the Body and Mind Feels Unsafe, Labor Slows Down

Feeling safe and comfortable during labor isn’t just about emotions, it also affects how your body gives birth. When you’re stressed or anxious, your body reacts with stress hormones, and that can slow things down or make labor harder.

When you feel anxious or unsafe during labor, your body can go into “fight or flight” mode. This releases adrenaline, which can actually block oxytocin, the hormone that helps your uterus contract. Without enough oxytocin, labor can slow down or even pause.

Your Body Is Protecting You

It’s your body’s way of protecting you. From an evolutionary point of view, giving birth in the wild—or in any unsafe environment—would have put both the birthing person and the baby at risk. If there was a predator nearby or something felt threatening, it wouldn’t be a good time to have a baby. So the body developed a way to pause or slow down labor until you were somewhere safe and calm again. That same protective response still exists today—even if the “danger” is just bright lights, strangers, noise, or feeling out of control. Your body doesn’t know the difference; it’s just trying to protect you. ​NPWF

Moreover, the release of stress hormones can cause blood vessels in the uterus to constrict. This reduces oxygen supply to the uterus and baby, and potentially increases pain perception. This creates a feedback loop where increased pain leads to more stress and further hormonal imbalance, complicating the labor process. ​Medico Publication (2020)

Safety Helps Labor Progress Naturally

On the other hand, when you feel calm, safe, and supported during labor, your body makes more oxytocin—the hormone that keeps contractions going and helps labor move forward. Oxytocin also helps ease pain naturally and makes you feel more relaxed and connected. ​Dr Sarah Buckley (2024)

That’s why creating a peaceful, supportive birth environment really matters. Things like reducing stress, having kind and steady support people, and making sure your needs are respected can make a big difference. Not only does it help you feel better emotionally, but it also helps your body do what it’s designed to do.

Why This Matters Even More for Neurodivergent Parents

For neurotypical people, a birth plan might focus mostly on medical choices. But for neurodivergent individuals, small environmental and social details can have a huge impact on how safe and regulated we feel. Things that might seem minor to others—like bright fluorescent lights, being touched without warning, or having to make small talk while in pain—can be deeply dysregulating.

These situations often trigger sensory overload, social masking, and a fight-or-flight stress response, which can stall labor and make the experience feel unsafe. Because of this, a birth plan for neurodivergent people needs to go deeper—taking into account sensory, communication, and emotional needs, not just medical preferences.

What to Include in a Birth Plan for Neurodivergent People

So what should you include in your personal birth plan? Here are some ideas to consider:

Sensory Needs

Many neurodivergent people are more sensitive to light, sound, touch, and general overstimulation—especially during something as intense as labor.
You might want to include:

• Dim lighting or the option to turn lights off
• Wearing an eye mask, sunglasses, or headphones
• Reduced background noise or playing your own calming music
• Avoiding strong smells (like essential oils or perfumes from staff)
• Minimal or no touch without warning

Communication Preferences

When you’re in labor, it can be hard to process information, answer questions, or explain what you need—especially if you’re masking or overwhelmed.
Things to include:

• Please speak clearly and directly—no small talk during contractions
• Repeat instructions if needed or provide them in writing
• Allow my partner/support person to speak for me if I go nonverbal or shut down
• Let me write down responses or use gestures if needed

Emotional Support

Feeling emotionally safe is just as important as physical care.
Consider adding:

• I respond best to calm, kind, soft-spoken people
• Please explain what you’re doing before touching me or performing a procedure
• I need time and space to make decisions—I may need a moment to process

Environment & Movement

Many ND people benefit from freedom of movement and physical stimming to stay grounded.
Helpful notes:

• I’d like access to a birth ball, tub, or place to walk/move around
• Please allow me to sway, rock, or stim as needed
• I may need quiet time alone or with just my partner at points

How to Share Your Neurodivergent Birth Plan With Your Care Team

Writing a birth plan is important. But just as important is making sure it actually gets read and respected. You don’t need to hand over a five-page essay (in fact, short and clear is best), but you do want your care team to understand what helps you feel safe and supported.

The best time to share your birth plan is before labor starts, during one of your prenatal appointments. That way, your midwife or doctor can talk through any questions or help make notes in your chart. You must also bring printed copies with you when you go to give birth because the personnel there may not know anything about it. 

What if They Don’t Read It?

When I was working as a midwife, the first thing I did when entering a room was to introduce myself, shake hands, and let the birthing person know that I was going to take a moment to read through their birth plan and wishes. After reading it, I’d come back and talk to them about anything I needed to clarify. It only took a minute or two, but it showed them right away that I respected their choices and was there to support them—not just medically, but emotionally too.

If your care provider doesn’t read your birth plan, let them know that you have one and that it’s important for you that they read it. You could try saying something simple like:

“I’ve written down a few things that help me feel more comfortable during labor. Would you mind taking a moment to look at them?”

Or have your partner/support person hand it over and speak on your behalf if you feel nervous about it or overwhelmed. You may have to ask more than one care provider to read it because childbirth often takes time and there may be shifting hospital staff. 

Be Prepared for the Unexpected

Childbirth can be quite an unpredictable process. You might have planned everything carefully, written out your birth plan, and communicated your needs clearly—and still, things might not go exactly the way you imagined. That’s completely normal.

One thing to keep in mind is that during labor, staff can change. A new midwife, nurse, or doctor might walk into the room at any point—even while you’re pushing. If things are calm, you or your partner can ask them to take a quick look at your birth plan. But sometimes, a new person might walk in at a very intense moment, and they may not have time to read anything right away. That’s okay.

In those cases, it can be really helpful if your partner or support person quickly lets them know that you’re autistic or otherwise neurodivergent, and that there are a few small things that help you feel safe. Just a sentence or two can make a difference, even in a busy moment.

When Things Don’t Go as Planned

It’s also important to be ready for the possibility that something might not go as planned. If an emergency happens, the staff’s top priority will be keeping you and your baby safe. They may need to turn on bright lights, touch you without warning, raise their voices, or ask you to do something quickly. The energy in the room might shift fast, and that can feel really overwhelming—but it doesn’t mean something is wrong with you or your plan. It means the team is acting fast to protect you.Try to go into labor with a mindset of flexibility and trust. You’ve prepared, you’ve advocated for your needs, and you’ve surrounded yourself with support. If things take a turn, let yourself trust the staff and trust the process. You can always come back to calm once it’s safe to do so.

Birth Plan for Neurodivergent People – Key Takeaways

• Neurodivergent people often need different things during labor—like dim lights, fewer questions, quiet space, or clear, direct communication.
  
• Feeling safe and calm isn’t a luxury—it’s part of what helps labor progress smoothly.
  
• A good birth plan for neurodivergent people includes sensory, emotional, and communication needs—not just medical choices.
  
• Keep your birth plan short and easy to read. Print it and share it early.
  
• Be prepared for changes—new staff, fast decisions, or things not going as planned. That’s normal.
  
• If something shifts, trust your team and come back to your calm when it’s safe to do so.
  
• You are allowed to ask for the environment and support that works best for your brain and body.