At the core of Obstetric Medicine is the art of collaboration and communication. This is never more true than with the management of a complex medical conundrum in a pregnant woman. Our case describes a young woman with severe lupus, quiescent preconception on a monoclonal antibody, presenting with worsening hypertension and proteinuria at a pre-viable gestation. Uncertainty surrounding the diagnosis, exacerbation of her complex regional pain syndrome, steroid-induced diabetes and significant radiation exposure were only some of the complexities complicating her 70-day admission. Her emotional and mental health, already borderline, was severely impacted. Underpinning all of this was a true multidisciplinary team of physicians, obstetricians, psychiatrists, nursing, midwifery and diabetes staff aiming to work collaboratively to safely prolong the pregnancy and ensure the best possible outcomes for mother and child.