Only a few decades ago, a diagnosis of lupus could mean giving up the dream of having children. Women with systemic autoimmune diseases like lupus were warned that pregnancy was too risky – both for them and their unborn babies. Fast forward to today, and the story is remarkably different.

Thanks to scientific research and medical advances, pregnancy outcomes have greatly improved over the past several decades, and the outlook for pregnancy in people with autoimmune disease is more hopeful than ever.

However, pregnant women with autoimmune diseases still face a far higher likelihood of having serious complications, including preterm birth or even fetal loss. So while the outlook has improved, navigating pregnancy with these conditions still comes with a unique set of challenges and considerations. This is due to the medicines used to treat the disease, the effects of inflammation on the body and imbalances of the immune system, including some that researchers like me don’t yet fully understand.

I’m a rheumatologist and biomedical researcher with medical training and expertise in rheumatology and reproductive health. Rheumatology is a medical specialty that treats people with systemic autoimmune and inflammatory diseases, like the ones discussed in this article. We’re sometimes thought of as arthritis doctors, but systemic autoimmune diseases can involve the whole body, and we care for all of those effects.

I think it is essential that women with autoimmune diseases are equipped with a realistic understanding of their potential pregnancy journey – both the advances that have made motherhood more possible for them and the risks that still remain.

Systemic autoimmune diseases are chronic medical conditions in which the immune system, which normally protects the body from infections, mistakenly attacks the body’s own tissues. These conditions can include lupus, rheumatoid........

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