Rheumatologic conditions occur in reproductive aged women, requiring a multidisciplinary approach to care. Patients require coordinated care with obstetrics, maternal fetal medicine, and rheumatology. Many drugs used for the care of rheumatologic conditions are safe in pregnancy, but detailed review should occur, ideally preconception, so the patient can be on the safest regimen while maintaining disease control. Anti-Ro/SSA and anti-La/SSB antibodies particularly pose unique risks of neonatal lupus syndrome, including cardiac manifestations. Medical management is unique to each disease and includes ultrasounds and antenatal testing to optimize both maternal and fetal well-being and minimize perinatal risks.