Rheumatic diseases can affect quality of life and reproduction. In previous decades patients with lupus were dissuaded from falling pregnant. Today, the majority of women with rheumatic diseases have successful pregnancies and healthy babies. In this presentation, Professor Hodkinson discusses two case studies. One, of a 24 year old social worker diagnosed with lupus in July 2017, who is feeling depressed about chances of healthy pregnancy in future. The other is of a 37 year old with ankylosing spondylitis, diagnosed 10 years previously and treated with NSAIDs. Professor Hodkinson talks about immunosuppressive drugs in pregnancy; the effect of pregnancy on rheumatic disease; the effect of the rheumatic disease on pregnancy; fertility; assisted reproduction; and, contraception. The presentation provides information on the safety of the various anti rheumatic drugs Hodkinson discusses the fact that pregnancy can induce remission in RA, with up to 50% of pregnant women going into remission during pregnancy. But, she stresses that there can be a post-partum flare. Hodkinson provides information on lupus in pregnant women and the implications of a flare during pregnancy which include, fetal loss; pre-eclampsia; eclampsia; fetal growth restriction; thrombosis; infection thrombocytopenia. The presentation concludes with a look at neonatal lupus syndromes which can present by way of rash or congenital heart block.