Behind the Paper - Walking Beside Mothers: How Continuity of Care Revealed a Hidden Pattern

My lived experience of a late ADHD diagnosis and years supporting First Nations mothers helped me see repeating patterns of missdiagnosis and dismissal. This paper grew from a promise to improve understanding and equity for neurodivergent women.
Behind the Paper - Walking Beside Mothers: How Continuity of Care Revealed a Hidden Pattern
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Integrative literature review – the impact of ADHD across women’s lifespan - BMC Women’s Health

Background Attention-Deficit/Hyperactivity Disorder (ADHD) and associated comorbidities in women are poorly recognised and often late diagnosed or misdiagnosed. This has significant negative impacts on the health and wellbeing of girls and women across their lifespan. Aim This integrative literature review aims to synthesize existing studies on the impacts of ADHD and associated comorbidities, as well as the challenges of delayed diagnosis and misdiagnosis for women and girls, focussing on critical life stages such as adolescence, perinatal, postnatal and (peri)menopause. Additionally, this review aims to identify evidence-based strategies for improving diagnosis, treatment, and support for this vulnerable population. Methods An integrative literature review was conducted using Whittemore and Knafl’s framework. Searches were performed in Embase, Cumulative Index for Nursing and Allied Health Literature (CINAHL), PubMed, National Library of Medicine (Medline), Scopus and Google Scholar (March - April 2025). Studies were selected based on defined inclusion and exclusion criteria, focussing on women and girls diagnosed with ADHD and their experience regarding diagnosis, comorbidities and treatment outcomes, were peer-reviewed, and published in English. Data was managed in Covidence and appraised using MMAT and AGREE II. Results The review identified and included ten studies (five qualitative, four cohort, one mixed-methods) and one guideline, published between January 2023 - April 2025, revealing five key developmental domains: Childhood and adolescence - late diagnosis and early comorbidities, Adulthood - hormonal impacts and comorbidities, Perinatal period - outcomes and challenges, Menopause and later life - hormonal transitions and late diagnosis, Cross-developmental treatment considerations - evidence gaps and women-specific approaches. Girls and women with ADHD frequently experience delayed diagnosis, leading to heightened risk of anxiety, depression and maladaptive coping strategies. Hormonal fluctuations were found to exacerbate ADHD symptoms, particularly during critical developmental phases such as puberty, the perinatal period, menopause and later life. Highlighting the need for tailored assessment, treatment and care approaches. Conclusion The findings highlight the urgent need to improve awareness of specific ADHD presentations in women and girls and better training for healthcare providers, aiming for earlier diagnosis and comprehensive individualised, tailored treatment strategies. Future research should focus on understanding the interplay between ADHD and its comorbidities, as well as exploring sex specific treatment options to improve health outcomes for women with ADHD.

My interest in this topic is rooted in both personal experience and years of working in primary health care. Like many women, I was diagnosed with ADHD later in life. That diagnosis reshaped how I understood my own history and it gave me a keen awareness of the patterns I had been witnessing for years in my clinical work as nurse and midwife.

Much of that work took place within the Australian Nurse Family Partnership Program, where I supported First Nations mothers from pregnancy until their child turned two. Continuity of care over such a long period created space for deep relationships to form. Mothers shared their childhood memories, adolescent challenges, and the realities of parenting. I often met multiple generations within the same family, and across these stories I began to see recurring themes: self-doubt, shame, coping strategies that had developed in response to years of feeling misunderstood, many women experienced trauma, and some shared comorbidities.

I advocated fiercely for these women, writing support letters, helping them navigate complex systems, and walking beside them as they sought assessment or diagnosis. Some were successful, but many encountered significant gatekeeping. Symptoms were dismissed, previous diagnosis were rarely reconsidered, and vulnerable women were often left without the support they needed. Misdiagnosis and dismissal were not isolated events; they were patterns.

Although I loved my work and the families I supported, I could only walk alongside a small caseload at any given time. The similarities in their experiences, combined with my own diagnosis, compelled me to look deeper. This led to my final Master of Primary Maternity Care project, where I conducted the literature review that ultimately became this paper. Roslyn Donnellan-Fernandez was my supervising professor and she supported me both in my writing and in the publication process.

With both sadness and excitement, I stepped away from clinical practice and into academia as an Associate Lecturer in Nursing at the University of Southern Queensland. I made a quite promise to the mothers I had supported: that I would continue this work through research, to connect the dots, to amplify their experiences, and to help improve the understanding and awareness of health professionals working with women across the lifespan.

This paper is one step in that journey. My long-term goal is to contribute to greater health equity for vulnerable women and for those living with neurodiversity. I am now planning to pursue a PhD, driven by the same commitment that began in those homes, sitting beside mothers who deserved to be heard, believed and supported.

Read the full paper here, https://link.springer.com/article/10.1186/s12905-025-04123-1

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Nursing Research
Life Sciences > Health Sciences > Nursing > Nursing Research
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Life Sciences > Health Sciences > Clinical Medicine > Diseases > Psychiatric Disorder > ADHD
  • BMC Women's Health BMC Women's Health

    This is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations.

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