Neurodivergence among healthcare professionals and implications for midwifery: A literature review

Abstract

Background: Societal awareness of neurodivergence is increasing and diagnostic pathways are becoming more accurate; more people are therefore pursuing assessments, often later in life. Health professionals, including midwives, may also be traversing this journey of self-discovery. Overseas estimates suggest that neurominorities may account for as much as 20% of the general population; this is a significant minority group. The healthcare professions require empathy and social skills, and neurodivergent (ND) people may be seen as unsuitable due to deficits in diagnostic, cognitive and communication skills. Research bias in favour of white males, alongside pervasive stereotypes, has contributed to the underdiagnosis of ND women and gender-diverse people. As a predominately female workforce, including ND colleagues will inevitably become more relevant to the midwifery workforce in the future. Aim: This integrative literature review asks: what is known about the workplace experiences of ND healthcare professionals? The intention is to reflect on the possible ramifications for midwives in Aotearoa New Zealand, and to establish a rationale for future research. Method: Google Scholar, PubMed, CINAHL and ProQuest databases were searched using combinations of key terms. Following the Critical Appraisals Skills Programme (CASP) evaluation, only ethics-approved, peer-reviewed papers in English were included. Findings: Nine studies investigating the workplace experiences of ND healthcare professionals were evaluated. The findings coalesced around two main concepts: (1) The internal experience, with sub-topics Diagnosis and disclosure, Strengths associated with neurodivergence, Sensory processing and Executive functioning; and (2) Navigating a neurotypical world, with sub-topics Social dynamics, Self-management strategies and Workplace accommodations. Conclusion: Ableist barriers to equitable employment experiences were pervasive throughout healthcare workplace settings. All nine studies highlighted workplace challenges for ND healthcare professionals, relating to social, sensory and executive function differences. The absence of literature specific to the unique contextual experiences of ND midwives in Aotearoa New Zealand signifies the scope for future research.