In clinic recently, I saw a 35-year-old woman who was suffering greatly from rheumatoid arthritis (RA), an autoimmune disease that causes chronic, painful inflammation and sometimes fusion of multiple joints. There are more than a dozen FDA-approved treatments for RA, and “Jane” had been taking one with good results. But two years ago when she began trying to get pregnant, her rheumatologist and her obstetrician advised her to stop taking her medication due to worries about possible effects on a developing fetus.

Over the next two years, not only had Jane not gotten pregnant, but she was experiencing significant pain. Her wrists were now severely swollen with very limited movement and likely had been permanently damaged. She had two questions for me: did she have to live in pain, and how could she get pregnant?

As a rheumatologist with a focus on pregnancy, I knew that there were ample data about the safety of the drug that had worked so well for Jane—data that showed no increases in birth defects, pregnancy loss, preterm birth, or neonatal infections. I told Jane she could resume taking her medication, and she and her husband left happy at the prospect of relief. I expect to see her back pregnant soon – we know that active RA prevents pregnancy in many women.