Frequently Asked Questions
Old advice was that women with lupus shouldn’t get pregnant. Is that still true?
No. This advice, which was common until the 1990s, has been superseded by decades of evidence demonstrating that planned lupus pregnancies in remission, managed by experienced specialists, have outcomes close to the general obstetric population. Blanket discouragement of pregnancy is no longer appropriate in most lupus cases.
Will my autoimmune disease be passed to my child?
Autoimmune diseases are not directly inherited in a simple Mendelian pattern. Having a parent with RA, lupus, or ankylosing spondylitis increases the child’s lifetime risk modestly but does not determine that they will develop the condition.
Can I have an epidural during labour if I’m on blood thinners (heparin)?
This requires careful planning. Heparin (commonly used for antiphospholipid syndrome in lupus pregnancy) must be paused before neuraxial anaesthesia. Your rheumatologist, obstetrician, and anaesthesiologist should have a written plan for the peripartum period, typically drawn up at 28–32 weeks.
I’m on biologic therapy and just found out I’m pregnant. What do I do?
Contact your rheumatologist promptly. Do not stop the biologic without guidance — for some patients, the disease flare risk from sudden cessation is significant. Your rheumatologist will advise on timing of drug discontinuation based on your specific biologic, your disease status, and gestational age.
Does the postpartum flare really happen?
Yes, postpartum flare is well-documented in RA and lupus. The immune changes of pregnancy that suppressed disease activity reverse rapidly after delivery. Have a plan with your rheumatologist for postpartum medication reinstatement or dose adjustment, particularly in the first 6 months after delivery.
This article is for educational purposes. It does not constitute medical advice. All medication decisions in pregnancy must be made with your rheumatologist and obstetrician. Dr. Keerthi Vardhan, MD (Internal Medicine), DM (Clinical Immunology & Rheumatology), Assistant Professor, NIMS Hospital, Hyderabad.