Systemic lupus erythematosus (SLE) disproportionately affects individuals of reproductive age and is associated with significant maternal and fetal morbidity during pregnancy, particularly in the setting of active disease or exposure to teratogenic medications. Clinical guidelines recommend proactive contraceptive counseling and pregnancy planning for individuals with SLE; however, real-world contraceptive use remains inconsistent, and unintended pregnancy rates are high. Racial and ethnic disparities in contraceptive access and uptake further underscore the need for patient-centered, equity-focused research in this population.

This cross-sectional study will assess potential barriers or facilitators for contraceptive uptake among English- and Spanish-speaking individuals aged 18–45 years with SLE receiving care within a large, diverse healthcare system. Using an electronic survey administered via Epic MyChart and in rheumatology clinics, we will collect data on reproductive history, current and prior contraceptive use, exposure to teratogenic medications, and pregnancy intention, measured using the validated Desire to Avoid Pregnancy (DAP) scale. We will also examine patient experiences with contraceptive counseling using the Interpersonal Quality of Family Planning (IQFP) scale and patient-reported perceptions of changes in SLE disease activity among those who initiated a new contraceptive method within the past 12 months.

Findings from this work can provide new information regarding contraceptive use in this population and support shared decision-making for individuals with SLE and their clinicians. Ultimately, this project seeks to improve reproductive autonomy among individuals with chronic autoimmune disease.