Pregnancy With Lupus Is Risky. Would She Be Able to Carry Her Baby to Ter...

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Pregnancy With Lupus Is Risky. Would She Be Able to Carry Her Baby to Term?

Fatimah Shepherd’s kidneys were compromised, and pregnancy could send her into kidney failure.

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Fatimah Shepherd, a New York City Fire Department dispatcher, lives with lupus, an autoimmune disease that wreaks havoc on the kidneys and disproportionately affects Black, Hispanic and Asian women.

By

Roni Caryn Rabin

Photographs by

Heather Khalifa

April 27, 2026,

8:15 a.m. ET

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Fatimah Shepherd knew she was not supposed to get pregnant — not now, while her illness was acting up, and maybe never.

Lupus, an autoimmune disease, was gnawing away at her kidneys, and doctors had warned her that pregnancy could tip her into full-blown kidney failure.

But in December 2023, there it was, a positive pregnancy test: two bold lines on the test strip, bright pink and indisputable.

“I almost passed out,” said Ms. Shepherd, 41, a New York City Fire Department dispatcher who lives in Brooklyn and had always wanted a child. “All I was thinking was, ‘What am I going to do?’”

For much of the 20th century, doctors instructed patients with lupus — a disease that strikes women during their prime childbearing years and that disproportionately affects Black, Hispanic and Asian women — to avoid pregnancy at any cost. The miscarriage rate was high, and pregnancy appeared to aggravate the disease.

That advice has changed in recent decades, as treatments have improved. But pregnancy can still be a precarious enterprise, and women with lupus that attacks the kidneys are advised to become pregnant during periods when their disease is stable and has been in remission for six months.

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