Many years ago (and more recently) we have looked at the pill in our lupus patients and have found that in general there are no major problems, especially with the mini pill. A small group of patients with antiphospholipid antibody (or anticardiolipin antibody) have more of a clotting tendency and obviously these patients present a totally different problem. In these patients oestrogen containing pills should be avoided.
The answer, perhaps surprisingly, is yes, although obviously common sense and good practice dictates that the fewer drugs used in pregnancy the better.
Obviously, there are many individual reasons for planning an early caesarian section, but do rest assured that this is common and generally beneficial for the baby. You really should not worry about having a premature baby at 36 weeks.
Statistically, the chances of having a flare in lupus are higher after delivery. Having said this, the chances are still small - only a small minority of our lupus patients have flares in the few months after delivery of the baby. Nevertheless, we like to watch our patients more closely at this time and monitor the urine and blood tests more frequently. If the test results become more abnormal, then we can at least step in earlier with more active treatment.
From what you say, there seems every chance of a successful pregnancy. Clearly, it is important to know that the lupus is relatively calm, both from the clinical point of view and from the tests, that the blood pressure and kidney function are reasonable and that the anticardiolipin antibody levels are not high (patients with high anticardiolipin antibodies have a higher risk of miscarriage and this can now be largely prevented). There is no specific need to routinely increase the steroids just because of the pregnancy.
The current view on this has changed over recent years in the light of two studies. Both studies suggest that providing the woman does not have antiphospholipid antibodies, the low-dose combined oral contraceptive should not significantly increase the risk of a lupus flare. In the presence of antiphospholipid antibodies ("sticky blood"), there is an increased risk of blood clots with the combined oral contraceptive. Progesterone is generally OK in APS patients. The Mirena Coil is also generally recommended by the Lupus-In-Pregnancy Clinic at Guys Hospital.
I am due to give birth in two weeks and am anti-ro positive (I have lupus/Sjögren’s with mild joint/fatigue symptoms, Hashimoto's hypothyroidism and Graves Eye Disease). I am concerned that breastfeeding whilst passing on my 'good' antibodies, might also pass on my bad antibodies. Is it possible to pass on anti-ro through breast milk?