The Lived Experiences of Autistic Mothers: A Systematic Review and Thematic Synthesis of Qualitative Evidence.

Background: Increasingly, research has explored autistic mothers' experiences of motherhood. However, understanding is largely based on single studies. Existing syntheses of qualitative and quantitative research are highly specific, focusing on pregnancy, sensory, infant feeding, and perinatal periods. Thus, a review taking a broader perspective which encapsulates autistic mothers' experiences beyond early motherhood is warranted. Aims: To systematically identify, appraise, and synthesize existing qualitative research on autistic mothers' experiences of motherhood to enrich understanding, and guide future research and practice. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and a qualitative synthesis of extant peer-reviewed qualitative studies and grey literature sources using Thomas and Harden Thematic Synthesis. Methodological rigor was assessed using the Critical Appraisal Skills Programme (CASP) checklist. Results: Three themes representing the collective experiences and perspectives of 629 autistic mothers from 23 primary studies were developed: "The Embodied Autistic Experience of Motherhood," "Navigating the Non-Autistic World as an 'Other' Mother" and "Recalibrating Identities." Conclusions: Autistic mothers report having unique autistic strengths and prioritizing their children. However, their experiences of motherhood are largely colored by autism-specific and identity-related challenges, and adverse experiences related to systemic, structural, and societal othering, specifically, from feeling policed, pathologized and overpowered by professionals. This translates into an increased prevalence of psychological difficulties and need for support. Further research, professional training, systemic changes, and societal awareness are urgently needed to inform understanding and support.