Lupus and Pregnancy in Grand Rapids, Michigan

Lupus most often affects women of childbearing age, including many in the Grand Rapids and West Michigan area. Lupus can increase the risk of complications during pregnancy, but with careful planning and close medical monitoring, most women with lupus are able to have healthy pregnancies and healthy babies.

In Grand Rapids, women with lupus can receive coordinated care through major health systems such as Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health, along with support from the Kent County Health Department and local rheumatology clinics.

Understanding Lupus and Pregnancy

Lupus (systemic lupus erythematosus, or SLE) is a chronic autoimmune disease. In lupus, the immune system—which normally fights infections—mistakenly attacks healthy tissues. This can affect many parts of the body, including:

  • Skin
  • Joints and muscles
  • Kidneys
  • Heart and blood vessels
  • Lungs
  • Nervous system

The result is ongoing inflammation, which can cause pain, fatigue, and damage to organs. Because pregnancy also places extra demands on the body, it’s essential that lupus is as well controlled as possible before you conceive.

In Michigan, where cold winters and frequent respiratory infections are common, managing lupus carefully is especially important. Seasonal changes, infections, and stress can trigger flares, which may affect pregnancy.

Planning a Pregnancy When You Have Lupus in Grand Rapids

Aim for Stable Lupus Before Conception

Healthcare providers in Grand Rapids generally recommend:

  • Waiting at least 6 months after your last lupus flare
  • Having no active lupus symptoms before trying to get pregnant

The healthier and more stable your lupus is before pregnancy, the greater your chance of:

  • A full-term pregnancy
  • Fewer complications
  • A healthy baby

Talk With Your Healthcare Team Before You Conceive

Before becoming pregnant, schedule pre-pregnancy consultations with:

  • Your GP or primary care provider
  • A rheumatologist (often at Corewell Health, Metro Health, or Trinity Health Grand Rapids)
  • A high-risk obstetrician (maternal–fetal medicine specialist), available at major Grand Rapids hospitals

Your doctors will:

  • Review your lupus history and current symptoms
  • Check your kidney function, blood pressure, and blood tests
  • Discuss your medications and whether any need to be stopped or changed
  • Screen for specific antibodies that may affect pregnancy (such as antiphospholipid antibodies)

Lupus Medications and Pregnancy Safety

Some lupus medications are safe in pregnancy, while others can harm a developing baby. It’s critical not to stop or change medications on your own.

Medications Often Unsafe in Pregnancy

These medicines are commonly not safe during pregnancy and may need to be stopped months before conception:

  • Methotrexate
  • Mycophenolate mofetil (CellCept)
  • Cyclophosphamide
  • Certain ACE inhibitors and ARBs used for blood pressure and kidney protection

Medications Sometimes Continued in Pregnancy

Depending on your situation, your doctor may continue or adjust:

  • Hydroxychloroquine (Plaquenil) – often recommended to stay on during pregnancy
  • Certain low-dose steroids (e.g., prednisone)
  • Some immunosuppressive medications that are considered safer in pregnancy
  • Low-dose aspirin or blood thinners (like heparin) if you have antiphospholipid antibodies or a history of blood clots

Your Grand Rapids rheumatologist and obstetrician will work together to create a medication plan that keeps your lupus controlled while protecting your baby.

How Lupus Can Affect Pregnancy

Most women with lupus in Grand Rapids can have successful pregnancies, but the risk of complications is higher than in women without lupus. These risks are why all lupus pregnancies are considered high risk and require close monitoring.

Possible Pregnancy Complications With Lupus

Women with lupus may have an increased risk of:

  • Lupus flares during pregnancy or shortly after delivery (postpartum)
  • High blood pressure (hypertension)
  • Pre-eclampsia – high blood pressure, fluid retention, and protein in the urine
  • Kidney problems or worsening lupus nephritis
  • Blood clots in the legs or lungs (deep vein thrombosis or pulmonary embolism)
  • Miscarriage
  • Preterm birth (babies born before 37 weeks)
  • Low birth weight
  • Emergency caesarean section

Your risk of complications is lower if:

  • Your lupus has been quiet (in remission) for at least 6 months before pregnancy
  • Your blood pressure and kidney function are stable
  • You attend all prenatal appointments and follow your treatment plan

In Grand Rapids, high-risk obstetric services at Corewell Health and Trinity Health Grand Rapids are experienced in managing pregnancies complicated by lupus and other autoimmune diseases.

Lupus Flares vs. Normal Pregnancy Symptoms

Some normal pregnancy symptoms can look like a lupus flare. This can make it hard to tell what’s causing your symptoms. Examples include:

  • Fatigue – common in both pregnancy and lupus
  • Joint pain or swelling – may be lupus-related or due to normal pregnancy changes
  • Skin changes – rashes, flushing, or darkening of the skin
  • Shortness of breath – can be normal in late pregnancy, but also a sign of lung or heart involvement
  • Hair loss after childbirth – can be normal postpartum or related to lupus

Because Michigan winters can worsen joint stiffness and fatigue, it’s especially important for women in Grand Rapids to communicate any new or changing symptoms to their care team.

If you notice:

  • New or worsening joint pain
  • New rashes or mouth sores
  • Sudden swelling of the legs, hands, or face
  • Severe headaches or vision changes
  • Shortness of breath or chest pain

contact your rheumatologist or obstetrician right away.

Antiphospholipid Antibodies, Blood Clots, and Placenta Problems

About one-third of women with lupus have antiphospholipid antibodies, which can increase the risk of blood clots and pregnancy complications.

How Antiphospholipid Antibodies Affect Pregnancy

These antibodies can:

  • Increase the risk of blood clots
  • Interfere with the placenta’s blood supply, especially in the second trimester
  • Lead to slow fetal growth, miscarriage, or preterm birth

If the placenta cannot supply enough oxygen and nutrients, your baby may not grow as expected. In some cases, this may require:

  • Early delivery, sometimes by caesarean section
  • Intensive monitoring of your baby’s growth and well-being

Treatment to Lower Clot and Miscarriage Risk

Your Grand Rapids doctor can:

  • Screen for antiphospholipid antibodies before and during pregnancy
  • Prescribe blood thinners (such as low-dose aspirin and/or heparin) if needed

This approach can help prevent blood clots and reduce the risk of miscarriage in many women.

Pre-eclampsia and Lupus

Pre-eclampsia is a serious condition that involves:

  • High blood pressure
  • Fluid retention (swelling)
  • Protein in the urine

It occurs in about 1 in 5 women with lupus and can endanger both mother and baby if not treated promptly.

Signs of Pre-eclampsia

Contact your provider or go to an emergency department at a Grand Rapids hospital if you experience:

  • Severe headaches
  • Blurred vision or seeing spots
  • Sudden swelling of face, hands, or feet
  • Pain in the upper right side of the abdomen
  • Sudden weight gain

Pre-eclampsia can often be managed with close monitoring and medication. In more severe cases, early delivery may be necessary to protect you and your baby.

Neonatal Lupus

Around one-third of women with lupus have antibodies that may cause temporary lupus-like symptoms in their baby, known as neonatal lupus.

What Is Neonatal Lupus?

Neonatal lupus is not the same as SLE. It can cause:

  • Skin rash
  • Abnormal blood counts (such as low platelets)
  • Rarely, heartbeat irregularities (congenital heart block)

In babies who do not develop heartbeat irregularities:

  • Symptoms usually disappear by 3–6 months of age
  • Long-term lupus is not expected

Heartbeat irregularities, when they occur, can often be detected before birth with fetal heart monitoring and treated by specialists in pediatric cardiology, available through major Grand Rapids health systems.

When You May Need to Delay Pregnancy

Some women with lupus should delay pregnancy and work closely with their Grand Rapids healthcare team to choose the safest time to conceive. This may include:

  • Women whose lupus is active or recently flared
  • Women with significant kidney disease (lupus nephritis)
  • Women taking medications that are unsafe in pregnancy, such as:
    • Methotrexate
    • Mycophenolate
    • Cyclophosphamide
  • Women with a history of:
    • Blood clots (thrombosis)
    • Recurrent miscarriages

If any of these apply to you, talk with your rheumatologist and obstetrician before trying to conceive. They can help:

  • Adjust your medications
  • Stabilize your lupus
  • Plan the safest possible timing for pregnancy

Medical Care Before and During Pregnancy in Grand Rapids

Before You Get Pregnant

Work with your Grand Rapids healthcare team to:

  • Achieve at least 6 months of stable lupus with no major flares
  • Optimize your blood pressure and kidney function
  • Review and adjust medications
  • Screen for antiphospholipid antibodies and other risk factors

During Pregnancy

Once you are pregnant, you will need:

  • Regular antenatal (prenatal) visits with a high-risk obstetrician
  • Ongoing care from your rheumatologist
  • Frequent monitoring of:
    • Blood pressure
    • Urine protein
    • Blood tests for lupus activity
    • Baby’s growth and well-being (ultrasound and other tests)

In Grand Rapids, high-risk pregnancy care is available at:

  • Corewell Health (Butterworth Hospital, Blodgett Hospital)
  • Trinity Health Grand Rapids
  • Metro Health – University of Michigan Health

Your healthcare team will work together to anticipate, prevent, and manage any complications.

Postpartum Period and Lupus

The weeks and months after delivery are a time when lupus flares can occur, especially as hormones shift and sleep is disrupted.

Common postpartum concerns include:

  • Fatigue
  • Joint pain or swelling
  • Hair loss
  • Mood changes or depression

Because West Michigan winters can add stress through cold weather, less sunlight, and higher rates of respiratory infections, it’s especially important in Grand Rapids to:

  • Keep all postpartum follow-up appointments
  • Contact your rheumatologist if you notice new or worsening symptoms
  • Discuss breastfeeding-safe medications with your providers

Local Resources for Lupus and Pregnancy in Grand Rapids

If you live in Grand Rapids or the surrounding West Michigan area, consider these resources:

  • Your GP or primary care provider – first point of contact
  • Rheumatologist – lupus specialist (available through Corewell Health, Metro Health, Trinity Health, and private practices)
  • Obstetrician or Maternal–Fetal Medicine Specialist – for high-risk pregnancy care
  • Nephrologist – if you have kidney involvement
  • Kent County Health Department – for public health support, vaccinations, and maternal health resources
  • Grand Rapids Public Health and local community clinics – for additional support and referrals

Key Points for Women With Lupus Planning Pregnancy in Grand Rapids

  • All pregnancies in women with lupus are high risk and require careful monitoring.
  • Aim to have no lupus flares for at least 6 months before trying to conceive.
  • Plan your pregnancy with your rheumatologist and a high-risk obstetrician in Grand Rapids.
  • Some lupus medications must be stopped or changed before pregnancy; do this only under medical guidance.
  • Many women experience stable or improved lupus during pregnancy if their disease was stable before conception.
  • Know the possible complications—such as pre-eclampsia, blood clots, miscarriage, and preterm birth—so they can be treated early.
  • With good planning, regular prenatal care, and support from Grand Rapids healthcare providers, most women with lupus can have healthy pregnancies and healthy babies.