People with chronic medical illnesses are at particularly high risk for adverse
pregnancy outcomes, yet current clinical approaches largely fail to identify and
support their individualized reproductive and pregnancy goals. Instead, the
predominant approach to pregnancy in subspecialty medicine is disease centered
rather than patient centered. To better meet the individual needs and
preferences of people with childbearing potential who have chronic medical
conditions, we advocate in this article for a paradigm shift in subspecialty
care that honors individuals' reproductive autonomy and human right of
reproduction.