There was a time when a lupus diagnosis came with a stern warning: “Don’t get pregnant!” For many, it was heartbreaking, but the risk to both mom and baby was too high. We’ve come so far since then! 

It’s true that there are some concerns to keep in mind and steps you may need to take before pregnancy if you have lupus — and this goes for both women and men with lupus — but the diagnosis doesn’t automatically rule out pregnancy and childbirth. 

Myths vs. Reality

We’ll go over the major concerns and some important things to consider if you are living with lupus and considering pregnancy, but first let’s take a look at common myths about pregnancy and lupus and set the record straight:

Myth: Having lupus means having children (or more children) is out of the question.

Reality: Most women living with lupus can become pregnant, have safe pregnancies, and deliver healthy babies! Well-controlled lupus is the key — and there are some lupus medications that can be taken safely during pregnancy.

Myth: Lupus increases the risk of having a child with birth defects.

Reality: Women with lupus may have a greater risk of pregnancy complications such as premature birth. They do not, though, have a greater chance of having a baby with a birth defect or intellectual disability compared to women without lupus.

Myth: A C-section delivery is required if you have lupus.

Reality: Many women living with lupus have vaginal deliveries! But just like deliveries for women without lupus, a C-section might be necessary if mom or baby is under stress or if certain complications arise.

Myth: Pregnancy always causes lupus flares.

Reality: Less than 1 in 3 women with lupus have flares during pregnancy. Studies show that waiting until your lupus has been controlled for at least 6 months before pregnancy can reduce the risk of flares – and when flares do occur they are usually mild and can be treated with corticosteroids. Some women even report that their lupus symptoms improve during pregnancy.

Myth: Babies born to moms with lupus will have neonatal lupus.

Reality: Neonatal lupus is rare, affecting less than two of every 100 lupus births. Babies with neonatal lupus may have a rash, liver problems, or low blood cell counts, but the symptoms usually go away completely within six months.

Myth: You can't breastfeed your baby if you have lupus.

Reality: Breastfeeding is possible with lupus, but be sure to talk to your doctor about whether any medications you are taking can pass through your breastmilk to your baby!

Pregnancy Risks with Lupus

If you have lupus and hope to become pregnant it’s important to know that certain complications are more likely, which means your pregnancy will be considered “high risk,” but there are also some things you can do to reduce the risks.

High blood pressure complications

These occur in about one in five lupus pregnancies. They are more common in women with kidney disease, a history of high blood pressure, or a history of smoking. Quitting smoking and having your lupus under control for at least 6 months before pregnancy can reduce the risk.

Miscarriage

About one in five lupus pregnancies results in miscarriage, but this is more likely in those with active disease, high blood pressure, kidney disease, and antiphospholipid antibodies. Waiting until your lupus has been controlled for at least 6 months and screening for antiphospholipid antibodies (followed by treatment with a blood thinner if antibodies are present) can lower miscarriage risk.

Preterm birth

About one out of every three women with lupus delivers early. Preeclampsia (a pregnancy complication involving high blood pressure and signs of organ damage), antiphospholipid antibodies, and active lupus all increase the risk of preterm delivery, so again, waiting at for at least 6 months after lupus is controlled and screening and treating for antiphospholipid antibodies can reduce risk.

In addition to maintaining lupus control, you can plan ahead and improve the chances of a safe pregnancy and healthy baby.

Review your medications

Let your doctor know your plans for pregnancy (6-12 months in advance, ideally) so you can have a preconception assessment and stop taking any medications that are dangerous during pregnancy, such as methotrexate, mycophenolate, cyclophosphamide, and warfarin, just to name a few. Some take a while to get out your system. Men with lupus who desire to conceive with a partner should also consult with their doctor in advance because some medications interfere with fertility.

Find a specialist

Look for or ask for a referral to a perinatologist — an obstetrician who specializes in high-risk pregnancies.

If you become pregnant, you can take good care of yourself and further reduce the risks by:

  • Staying on top of your lupus care.
  • Attending all of your prenatal visits.
  • Telling your doctor about any new or unusual symptoms so they can be evaluated.
  • Getting plenty of rest.
  • Eating healthy and avoiding too much weight gain.
  • Avoiding smoking and drinking alcohol.

If you are considering pregnancy and have questions or need some guidance, your Health Advisor can help you find the information you need! Just ask — we’re here for you!