“Twenty-five years ago, a woman with lupus probably would not have considered having kids, because she simply couldn't physically take care of them” because of crushing fatigue that often is part of the disease, says Eliza Chakravarty, a rheumatologist at the Oklahoma Medical Research Foundation. “But today, for many of these women, it's not only feasible to have kids, but desirable.”
Earlier diagnosis and medications now enable women with lupus to slow down the progression of their disease and treat many of the symptoms, enabling them to “live more fully in their lives,” she says. “When somebody comes to me now and says, ‘I'm thinking about having a baby,' I let her know that in the majority of cases, women will have safe and healthy pregnancies. But we need to do a little bit of work before they conceive to maximize the chances of a good outcome.”
The most important approach is to ensure that the drugs women are taking are okay to use during pregnancy, and, if they are not, to wean women from them and get them on safer substitutes.
