Discussing brain differences is popular right now. Many people—especially those who identify as women or who were assigned female at birth (AFAB)—are discovering that their brain differences fit the description of neurodivergence (ND), rather than having a neurotypical (NT) brain. In recent years, women who were previously diagnosed with ADHD and/or sensory processing disorders are realizing that their features also fit an autism diagnosis. When I was diagnosed as neurodivergent in 2018, I was told, “Women don’t have autism. Women are neurodivergent. Only men have autism.” Autism presents differently in people assigned male at birth (AMAB). Men who identify as autistic or on the spectrum are often perceived as socially awkward and are accused of lacking warmth or sensitivity.

Females, because of differing hormonal biology and gendered social training, often learn skills—or scripts—to cover our innate awkwardness. Beginning around eighteen months of age, estrogen levels rise in girl children, influencing them to interact more with older females (Brizendine, 2007). From an early age, we are taught the social behaviors needed to survive, including making eye contact during communication. This estrogen surge continues for about a year and a half, then drops to a baseline level that remains until puberty.

People on the autism spectrum are often described as having persistent interests—topics we return to again and again. My persistent curiosity has always been human behavior: trying to figure out why people do what they do. I have multiple degrees in Interpersonal Communications and Human Development. From a therapeutic standpoint, this fascination helps make my world more predictable and understandable. It also means I am never bored; there is always a living laboratory of humans being humans.

It’s also why most people miss my autism. Because I am endlessly fascinated by people, they often talk about themselves. I get to continually test my hypotheses about the right thing to say and the right way to respond. Even after six decades on the planet, I still feel like I’m figuring that out—and sometimes still failing.

Over the years, I’ve discovered that neurodivergent people are often very successful as doulas, and that we share both common talents and common challenges. While everyone is an individual, some patterns emerged through our conversations. Neurodivergent doulas are often sensitive, empathetic, and attuned to what to say and do—and when to say and do it—in the labor room. We also share a feistiness and drive to improve birth and family life. That drive colors everything else we do.

Neurodivergence often brings heightened sensitivity, which works in our favor during labor support. The slower pace, dim lighting, and singular focus of the labor room bring out the best in our brains. Many of us thrive in low-sensory environments. We can do more for longer periods of time.

I remember cataloging countless details during births, which helped me form a coherent picture of my client’s labor. One of the ways my brain diverges is that I’m often tracking multiple things at once. What’s in the “main channel” rotates. At a birth, I’m simultaneously aware of what’s happening in my client’s body, anticipating what might happen next, tracking what medical providers are doing and thinking, and monitoring what’s happening in my own body and what adjustments I need to make. Birth is like a human strategy game—think Survivor or Big Brother—and I’m often thinking three or four moves ahead.

Another advantage of labor support for ND or autistic doulas is that both the labor room and prenatal visits follow relatively narrow social scripts, even with variation. Once we learn the effective behaviors, we can authentically fulfill the role with confidence. Early on, many ND doulas struggle with self-belief. Because there are so many social situations we find difficult, it can be hard to imagine we could be successful here.

I spent years learning the social rules of hospitals: how protocols differ from Hospital A to B to C; which practitioners were collaborative and which were authoritarian; and, most importantly, how to read a nurse. Over time, I turned these observations into concrete guidelines that I now teach in my doula trainings.

What people need from their doula in the prenatal relationship doesn’t vary much. They want someone who inspires them, answers their questions, is dependable and responsible, and sees something in them that sparks genuine warmth. They want to feel special. Once you understand the what, the how becomes easier over time.

Eye contact is one of the more controversial topics. I can’t tell you how many times I’ve been told, “You’re not autistic—you look at me when I talk to you.” Do you have any idea how much I hate doing that? My eye contact is as automatic as saying “I’m sorry” when someone needs to pass you in a crowded room—even when you have nothing to apologize for. Is it pleasurable? No. Do I like doing it? No. If given a choice, would I look at you while you’re talking? Maybe—off and on—because I do like faces, just not as much as I’ve been socially trained to perform.

In our ND doula conversations, we talked about how eye contact during labor support feels different than during social conversation. It’s purposeful, mutual, and bearable. Maybe it’s because we don’t have to track words and search for hidden meanings at the same time. Maybe it’s the oxytocin in our own brains soothing us. Many of us described entering a state of “flow” during extended eye contact—feeling deeply connected and able to predict and meet our client’s needs more accurately.

Finding the right client match is essential for ND doulas and those on the autism spectrum. Comfort with touch varied widely among our group. Some were not very “touchy” people and referred clients who wanted massage or extensive hands-on support to other doulas. Others needed clients who communicated clearly and asked directly for what they wanted.

One doula shared:
“The worst client for me is someone passive or passive-aggressive. I spend so much energy trying to figure out what they want that it’s exhausting. Sometimes I don’t realize this until after the contract is signed. Now I bring in a helper for visits—a newer doula who can serve as a buffer and offer insights I might miss. I never feel badly asking for help anymore. It only makes me a better doula.”

We talked honestly about our struggles, but mostly we shared how we’ve learned to compensate for our challenges. Disorganized people use software for client records. Resources exist for appearance, interviewing, and every other relevant doula skill. It’s the world that tells us we’re broken or lesser or incapable. It’s the world that tries to rob us of confidence or make us anxious about being inadequate caregivers. My social environment teaches me to oppress myself.

ND doulas also discovered shared challenges around conflict. Many of us had experienced surprise conflicts with other doulas—situations where our behavior was interpreted in ways we never intended or anticipated. Because those interpretations were so foreign to us, we struggled to respond effectively. When conflicts occurred publicly—in meetings or on social media—we often felt shame and shut down. Some of us never addressed the conflict because we didn’t know how. Others engaged, only to have it go badly. All of us had experienced unrepaired ruptures that ended relationships. None of us disclosed our neurodivergent identities at the time, even though we found these situations confusing and painful.

Many of us have also felt ostracized within doula organizations. Observed behaviors are misunderstood, and learning the social norms of conferencing can be exhausting. When I started my own organization, we made a deliberate choice to welcome and prepare for neurodiversity—in clients, doulas, faculty, and leadership. It feels different than any organization I’ve been part of before.

Being neurodivergent has not been easy. Saying the wrong thing at the wrong time has cost me friendships, colleagues, and job opportunities. It forced me to work independently. I doubt myself. Right now, I’m on the edge of a major business venture. On bad days, I wonder if I’ve watched too much Star Trek and am too idealistic about people. On good days, I remind myself of something Dr. Christiane Northrup said years ago: “It’s never crowded on the leading edge—that’s why it’s lonely.”

What’s the alternative? To let the world limit us?

As neurodivergent people, it’s time to show our strengths.

Brizendine, L. (2007) The Female Brain. Harmony Press. New York