The PRAISE-H study is a nationwide multicenter prospective registry of rheumatoid arthritis (RA) patients of reproductive age in Japan that captures challenges in daily life. Physician ratings and patient-reported outcomes are collected biannually through REDCap for 5 years, with dedicated follow-up during pregnancy and up to 12 months postpartum. As of November 2024, 100 patients (90 women and 10 men) were registered, of which 77 patients (70 women and 7 men) were followed up. Preliminary analyzes showed that 62% of women expressed a current or future intention to become pregnant. Considerable financial toxicity has been observed, particularly in patients taking biologic disease-modifying antirheumatic drugs (bDMARDs). The study provides insight into patient experiences in a real-world environment beyond database research. The findings can serve as a source of clinical recommendations and health policy initiatives to improve the management of RA in women of childbearing age. Although bDMARDs are considered viable during pregnancy, their financial implications require further investigation.