Living with an autoimmune condition often means you’re used to planning ahead, tracking symptoms and adjusting to protect your health.
If you’re considering pregnancy (or already pregnant), you may be asking yourself: Will my condition affect my baby? Can I do this safely?
The answer is reassuring: Yes!
“You can have a healthy pregnancy even if you have an autoimmune condition,” said Jennifer Garate, a certified nurse midwife with Banner - University Medicine. “With the right care, many people go on to have smooth, healthy experiences.”
Garate walks us through what to expect and how to prepare, from pre-pregnancy planning to postpartum recovery.
Understanding autoimmune disorders in pregnancy
Autoimmune disorders affect the immune system. They cause the immune system to attack the body’s own tissues.
Some common conditions include:
- Systemic lupus erythematosus (SLE)
- Rheumatoid arthritis
- Type 1 diabetes
- Multiple sclerosis
- Hashimoto’s thyroiditis
- Inflammatory bowel disease
- Antiphospholipid syndrome
Pregnancy changes the immune system in unique ways:
- Some conditions, like rheumatoid arthritis, often improve during pregnancy.
- Other conditions, such as lupus, may flare up or worsen.
- Antiphospholipid syndrome increases the risk of blood clots, miscarriage and pregnancy complications if not well managed.
- Autoimmune conditions may also raise the chance of preterm birth or low birth weight.
“Your immune system adapts during pregnancy to protect the baby, which can temporarily calm autoimmune activity,” Garate said. “But after delivery, it reboots and sometimes overreacts.”
Knowing this ahead of time helps you and your health care providers prepare for each stage.
Step one: Plan ahead with preconception counseling
“Preconception visits give us time to make adjustments and set you up for the healthiest experience possible,” Garate said.
Studies show that preconception counseling reduces flares and improves pregnancy outcomes.
During this visit, you may meet with your rheumatologist, health care provider or OBGYN and sometimes a high-risk pregnancy specialist. Together, you’ll:
- Review your condition and recent symptoms
- Adjust medications to pregnancy-safe options
- Talk about possible risks for you and your baby
- Create a plan for monitoring and support throughout pregnancy
Step two: Understand your medications
Not all medications are safe to take during pregnancy. Some, like methotrexate or mycophenolate, can cause birth defects. Others, such as hydroxychloroquine and sulfasalazine, are considered safe and may even protect against flare-ups.
Whatever the case, it’s important not to stop or change your medications on your own. Suddenly quitting can trigger dangerous flares or put both you and your baby at risk.
“Your care team will help you switch to safer alternatives, monitor drug levels and side effects and balance your health with your baby’s safety,” Garate said.
[Read more about safe medications during pregnancy.]
Step three: Take care of your mental health
Pregnancy with a chronic condition can bring mixed emotions. Along with your joy and excitement, you may also feel stressed and worried.
“Pregnancy with an autoimmune condition isn’t just about the physical side,” Garate said. “Your emotional health matters, too.”
Ways you can support your mental health:
- Talk with a therapist familiar with chronic illness
- Join a support group, such as Beyond the Blues, Banner Health’s free virtual support group
- Ask your providers to include mental health check-ins as part of your prenatal care
Step four: Build a strong support system
You don’t have to go through this journey alone. “Pregnancy with an autoimmune condition isn’t a solo mission, it’s a team sport,” Garate said.
Surround yourself with people and resources who can help manage stress and daily needs. That may include:
- Your partner, family and friends
- Health care providers with experience in high-risk pregnancies
- Trusted online resources, like ACOG’s Compassionate Conversations webinars
- Mental health organizations such as Postpartum Support International (PSI) and National Alliance on Mental Illness (NAMI)
Step five: Stay on top of prenatal care
With an autoimmune condition, you may need more frequent prenatal visits. This allows your care team to monitor your health and your baby’s growth, adjust medications as needed and quickly address any issues.
Extra tests may include:
- Bloodwork to track inflammation and hormone levels
- Additional ultrasounds to monitor development
- Blood pressure and blood sugar checks, since certain conditions increase risk
Consider these visits as an added reassurance, helping you stay ahead of potential problems.
Step six: Focus on daily wellness
Nutrition, rest and stress management all support your immune system and help keep you feeling well. Focus on:
- Balanced nutrition: Eat a variety of fruits, vegetables, lean proteins and whole grains. Your provider may recommend supplements if you’re at risk for deficiencies.
- Movement: Gentle activities, such as walking, swimming, or prenatal yoga, can help ease stiffness and boost energy.
- Rest: Listen to your body and prioritize sleep. Don’t be afraid to ask for help when you’re tired.
- Stress management: Try breathing exercises, meditation or quiet breaks during the day.
Step seven: Prepare for postpartum recovery
The weeks after delivery are often the hardest for people with autoimmune disorders. Flares are common, especially if your condition improved during pregnancy. Add in hormone shifts, sleep deprivation and the demands of a newborn and this stage can feel overwhelming.
Plan ahead with your team for:
- Early postpartum visits
- Medication changes, including breastfeeding-safe options
- Mental health check-ins for postpartum depression or anxiety
- Support at home for meals, childcare or rest
The bottom line
Pregnancy with an autoimmune condition does not have to feel scary. “Having an autoimmune condition doesn’t define your pregnancy,” Garate said. “With thoughtful planning, open communication and strong support, you can navigate this journey with confidence and joy. You’ve got this.”
If you’re planning for pregnancy or already expecting, schedule an appointment online with a Banner Health specialist.
