Health Team

Care, monitoring opens motherhood to women with lupus

Pregnancy has long been a dream denied for many women with lupus, a chronic autoimmune disease that attacks healthy tissue and organs. Now, medications and special care can help those women enjoy a safe pregnancy, and ultimately a healthy baby.

Posted Updated

By
Allen Mask
, M.D., WRAL Health Team physician

Pregnancy has long been a dream denied for many women with lupus, a chronic autoimmune disease that attacks healthy tissue and organs.

Now, medications and special care can help those women enjoy a safe pregnancy, and ultimately a healthy baby.

Emily Greenwell, 34, is a nurse manager at Duke's Rheumatology Clinic. She is also is within weeks of having a baby.

"Our journey began four-and-half years ago prior to us getting pregnant this year," she said.

At around age 28, Greenwell had been on medications to control lupus, an autoimmune disease that mainly affects her skin. She and her husband wanted to have a child, but first, she asked her rheumatologist.

"He advised me to come off my medications saying that it wasn't safe to get pregnant and still take the medication," she said.

That led to multiple symptom flare-ups, and still she couldn't get pregnant.

Many women with lupus don't even try to start a family.

Duke University rheumatologist Dr. Meghan Clowse said, "In the past people told women, you just can never have a child and that's that."

Clowse is one of only a handful of doctors in her field who specialize in helping women with autoimmune disease have a safe pregnancy.

The concern had always been that immunosuppressant and steroidal medications might harm a developing baby.

"Fortunately, we have lots of good data to suggest that a lot of our medicines don't cause birth defects," Clowse said.

Clowse works closely with Greenwell's high-risk pregnancy obstetrician to manage pregnancy care for patients with lupus or other autoimmune diseases.

Most women don't know where to go for that type of special care.

"One of my goals is actually that rheumatologists get better at this and are more comfortable with the medications that are safe in pregnancy and are more comfortable having these conversations with women," Clowse said.

With that special care and monitoring her medications, Greenwell says everything has gone smoothly.

"I've just been enjoying it and enjoying how I have felt physically, mentally and emotionally throughout this process, and we are excited for the next chapter," she said.

Clowse says many pregnant women with lupus – with proper control of their medication – can breastfeed once their baby is born.

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