It is recognized that diagnostic rates of autism in women is increasing and with this, areas such as pregnancy and childbearing need to be viewed through a neurodivergent lense. As autistic women have children and take on the challenges of motherhood, systematic reviews are needed to provide an orderly and up-to-date base highlighting the existing research gaps. This study aims to identify and analyze research that has addressed the childbearing experiences and mental health of autistic mothers, delineate trends in research, and identify areas for future studies. The protocol of this systematic review was registered in the international database of systematic reviews PROSPERO (registration number: CRD42022368244). In this work, the guidelines of standards for systematic reviews and meta-analyses (PRISMA) were followed at all stages. The review identified 15 studies that explored the childbearing experiences and mental health of autistic mothers. Results indicate that autistic mothers are more likely to experience parenting difficulties, intense sensory experiences during prenatal, perinatal and postnatal periods, and mental health problems. However, there are studies that highlight that autistic mothers can receive the same social support and experience marital satisfaction. The findings of this review suggest that, to improve our understanding of the childbearing and mental health experiences of autistic mothers, studies should include multiple informants and mixed methodologies. Additionally training programs need to be co-produced to raise awareness in health care personnel. © 2024 The British Society of Developmental Disabilities.